Media type: E-Article Title: Electrocardiogram score predicts severity of pulmonary embolism in hemodynamically stable patients Contributor: Golpe, Rafael; Castro‐Añón, Olalla; Pérez‐de‐Llano, Luis A.; González‐Juanatey, Carlos; Vázquez‐Caruncho, Manuel; Méndez‐Marote, Lidia; Carmen Fariñas, María imprint: Wiley, 2011 Published in: Journal of Hospital Medicine Language: English DOI: 10.1002/jhm.868 ISSN: 1553-5606; 1553-5592 Origination: Footnote: Description: <jats:title>Abstract</jats:title><jats:sec><jats:title>BACKGROUND:</jats:title><jats:p>Risk stratification of patients with pulmonary embolism (PE) is essential to guide therapy. The presence of right ventricle dysfunction (RVD) and the anatomic extent of PE have been suggested to predict clinical course. The aim of this study was to assess the ability of an electrocardiogram (ECG) scoring system to predict RVD or the clot load score in normotensive patients with PE.</jats:p></jats:sec><jats:sec><jats:title>METHODS:</jats:title><jats:p>Consecutive patients presenting to the emergency room with PE and hemodynamic stability were prospectively included. ECG, echocardiography and computed tomography pulmonary angiography (CTPA) were performed on all patients.</jats:p></jats:sec><jats:sec><jats:title>RESULTS:</jats:title><jats:p>A total of 103 patients were studied. ECG score correlated significantly with the clot load score (r = 0.41, 95% confidence interval [CI]: 0.22‐0.57, <jats:italic>P</jats:italic> < 0.001), systolic pulmonary artery pressure (r= 0.31, 95% CI: 0.09‐0.49, <jats:italic>P</jats:italic> = 0.006), pulmonary artery diameter (r = 0.28, 95% CI: 0.07‐0.47, <jats:italic>P</jats:italic> = 0.011) and right ventricle to left ventricle ratio, both measured with echocardiography (r = 0.42, 95% CI: 0.22‐0.57, <jats:italic>P</jats:italic> < 0.001) and with CTPA (r= 0.36, 95% CI: 0.13‐0.56, <jats:italic>P</jats:italic> = 0.004). Area under the receiver operating characteristic curve for detecting RVD was 0.82 (95% CI: 0.72‐0.89). Interobserver agreement regarding ECG score was substantial (κ = 0.80).</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS:</jats:title><jats:p>ECG score correlates with the severity of PE in hemodynamically stable patients. It is potentially useful for risk‐stratification strategies in this setting. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine</jats:p></jats:sec>