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Prognosis of pulmonary embolism: 30-day mortality risk based on three admission parameters – the PoPE score
Session:
Painel 9 - Doença Valvular 9
Speaker:
Daniel Faria
Congress:
CPC 2020
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
Subtheme:
21.2 Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Daniel Candeias Faria; Pedro Silvério António; João Baltazar Ferreira; Marco Beringuilho; Hilaryano Ferreira; Inês Fialho; Afonso Nunes Ferreira; Joana Simões; David Cabrita Roque; João Bicho Augusto
Abstract
<p><em>Backgroud and Purpose - </em>Various scoring systems were developed for risk stratification and mortality prediction in patients with acute Pulmonary Embolism. The Pulmonary Embolism Severity Index (PESI), and its simplified version (sPESI), are widely used, however, the elevated number of parameters make them difficult to use an apply in everyday practice. Our aim was to provide a simple and easy-to-perform score based on three clinical and metabolic parameters obtained at admission and to compare its performance to predict 30-day mortality.</p> <p><em>Material and methods - </em>In a retrospective observational study, 835 patients with confirmed PE were admitted in one medical center. Multivariate analysis was performed to identify clinical and analytical independent predictors of mortality at 30 days (primary endpoint). The model was validated in 280 patients from a second hospital.</p> <p><em>Results –</em> The primary endpoint occurred in 207 patients (73 in the validation cohort). Three independent prognostic risk factors were identified: Modified Shock Index ≥ 1.10 (OR 2.85, 95% CI, 1.74-4.69, p<0.001), Altered Mental State (OR 3.81, 95% CI, 2.32-6.28, p<0.001) and Lactate concentration ≥ 2.50 mmol/L (OR 4.12, 95% CI, 2.48-6.85, p<0.001). Based on the similar beta coefficient values for each variable, we attributed 1 point in the presence of each previous conditions, with a total score range from 0 to 3 - PoPE score. Reciever operating characteristic analysis showed good discrimination for the new model in the derivation (AUC 0.817, 95% CI 0.779-0.854, p<0.0001) and in the validation cohort (AUC = 0.803 95% CI, 0.736-0.858, p<0.0001). </p> <p><em> </em></p> <p><em>Conclusions</em><em> -</em> Our model proves an easy and simple tool with good performance which can predict early 30-day mortality in patients admitted for PE</p>
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