SPC365

PERFORM Score: A Prognostic Tool for Predicting Need for Fibrinolysis in Pulmonary Embolism

Session: Sessão de Posters 02 - Embolia Pulmonar
Speaker: Mariana Isabel Duarte Almeida

Congress: CPC 2024
Topic: F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme: 21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
Subtheme: 21.4 Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure - Treatment
Session Type: Cartazes
FP Number: ---
Authors: Mariana Duarte Almeida; Gonçalo Ferreira; João Gouveia Fiuza; Vanda Devesa Neto; Inês Pires; Nuno Craveiro

<p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-family:&quot;Abadi MT Condensed Light&quot;,sans-serif">Background: </span></strong><span style="font-family:&quot;Abadi MT Condensed Light&quot;,sans-serif">Pulmonary embolism (PE) is a potentially lethal condition presenting to emergency departments, which requires precise risk stratification for timely intervention. The Pulmonary Embolism Severity Index (PESI) score is widely used for acute PE severity assessment. However, obtaining comprehensive information in the emergency setting, particularly regarding comorbidities like cancer and chronic pulmonary disease, can be challenging. Consequently, there is a need to evaluate streamlined scoring systems for rapid decision-making. The validated Pulmonary Embolism Risk score FOR&nbsp;Mortality (PERFORM) score, utilizing age, heart rate, and partial pressure of arterial oxygen, has been used to predict mortality in PE patients. This study aims not only to assess PERFORM&rsquo;s capacity to predict mortality outcomes, but mainly to predict fibrinolysis requirement in PE-diagnosed patients.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-family:&quot;Abadi MT Condensed Light&quot;,sans-serif">Methods: </span></strong><span style="font-family:&quot;Abadi MT Condensed Light&quot;,sans-serif">Retrospective data from 198 patients admitted due to intermediate or high-risk acute PE in a Cardiology Department were analyzed. Demographic information, admission clinical data, treatment choices, and mortality outcomes were examined.&nbsp;The PERFORM score was calculated for each patient. Independent t-test was used for group comparison.&nbsp;Logistic regression was used to assess the association between PERFORM and outcomes. The score&#39;s ability to predict fibrinolysis and mortality outcomes was evaluated using Receiver Operating Characteristic (ROC) curves and Area Under the Curve (AUC) values.&nbsp;</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-family:&quot;Abadi MT Condensed Light&quot;,sans-serif">Results:</span></strong><span style="font-family:&quot;Abadi MT Condensed Light&quot;,sans-serif"> In the analyzed cohort of 198 patients (59.1% females, mean age 63.1 &plusmn; 17.9 years), 50.5% underwent fibrinolysis, and 6.6% experienced in-hospital mortality.&nbsp;</span></span></span><span style="color:#000000">Patients that undergone fibrinolysis had a higher PERFORM score (6.0 &plusmn; 2.0), comparing with those submitted to a conservative approach (5.2 &plusmn; 2.2). The independent t-test indicated a statistically significant difference between the groups (p=0.007). This suggests that PERFORM score can predicted need for fibrinolysis, yielding an odds ratio of 1.212 (p=0.009; 95% CI: 1.049-1.400). ROC analysis resulted in an AUC of 0.611 (p=0.009, 95%CI 0.528-0.694), indicating a moderate discriminatory capacity. However, the PERFORM score did not predict mortality (p=0.777; CI 95%: 0.376-0.671).</span></span></p>

<p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-family:&quot;Abadi MT Condensed Light&quot;,sans-serif">Conclusions: </span></strong><span style="font-family:&quot;Abadi MT Condensed Light&quot;,sans-serif">In our population, PERFORM score lacked ability to predict mortality, but showed</span><span style="font-family:&quot;Abadi MT Condensed Light&quot;,sans-serif">&nbsp;some capacity to predict need for fibrinolysis, especially in settings that are information-constrained and time-sensitive. Nevertheless, both low and high PERFORM scores lack conclusive determination for the optimal therapeutic approach.&nbsp;Attending physicians should integrate clinical data, incorporating the PERFORM score, while carefully weighing risks and benefits associated with fibrinolysis. Prospective refinements in scoring systems hold promise for tailoring interventions to maximize benefits for individual patients.</span></span></span></span></p>