Description:
Our aim was to analyze possibility of combination of basic clinical and radiological signs to predict 30-day mortality after acutepulmonary embolism (PE). We included 486 patients. Age, gender, simplified pulmonary embolism index (sPESI), pH, troponin,N-terminal natriuretic peptide, minimal systolic and diastolic blood pressure, O2 saturation, syncope, need for vasopressors,thrombotic obstruction, vessel diameter, short axis ratio right ventricle/left ventricle, and contrast medium reflux into the inferiorvena cava (IVC) were analyzed. A backward algorithm in a logistic regression model was used to identify relevant risk factors.Multiple logistic regression analysis identified that sPESI, pH, minimal diastolic blood pressure, IVC reflux, and need for vasopressors influenced 30-day mortality. A score for mortality prediction was constructed (the Pulmonary Embolism MortalityScore): sPESI >2 points (1 point), pH <7.35 (1 point), minimal diastolic blood pressure <45 mm Hg (1 point), IVC reflux (1 point),and need for vasopressors (2 points). Patients with >3 points showed higher 30-day mortality (sensitivity: 84.9%, specificity: 83.0%,positive predictive value: 51.8%, negative predictive value: 96.2%). The net reclassification improvement compared with the sPESIwas 0.94 (95% CI ¼ 0.73-1.15). In conclusion, a new score can predict 30-day mortality in patients with PE and is more sensitivethan sPESI