VALIDATION STUDY
Add like
Add dislike
Add to saved papers

The validation and reproducibility of the pulmonary embolism severity index.

SUMMARY BACKGROUND: Rapid, accurate risk stratification is paramount in managing patients with acute pulmonary embolism (PE). The PE Severity Index (PESI) is a simple tool that risk stratifies patients with acute PE.

OBJECTIVES: We sought to validate the PESI as a predictor of short- and intermediate-term mortality and to determine the inter-rater variability.

PATIENTS/METHODS: We retrospectively identified all patients with acute PE between October 2007 and February 2009. Two clinicians reviewed charts and independently scored PESI blinded to each other and to patient outcomes. Thirty- and 90-day mortality served as study endpoints and vital status was assessed via the Social Security Death Index. To facilitate analyses, raw PESI score was converted into risk class groups (I-V) and further dichotomized into low risk (I-II) vs. high risk (III-V) groups. Intraclass correlation and the kappa statistic were used to determine inter-rater variability.

RESULTS: The cohort included 302 subjects (mean age, 59.7 +/- 17.2 years; 44% male). All-cause 30- and 90-day mortalities were 3.0% and 4.0%, respectively. The mortality rate increased as raw PESI score increased. Risk of death correlated with risk class (P < 0.001). There were no deaths in risk classes I-III, but 30- and 90-day mortality for class V were 9.2% and 10.5%, respectively. Overall, mean PESI scores were similar between observers: 103.3 +/- 39.3 and 96.5 +/- 37.6 (P = NS). The inter-rater variability was good (kappa = 0.69; P < 0.0001).

CONCLUSIONS: The PESI correlates with 30- and 90-day mortality. It represents a reproducible scoring tool to risk stratify patients with acute PE.

Full text links

For the best experience, use the Read mobile app

Group 7SearchHeart failure treatmentPapersTopicsCollectionsEffects of Sodium-Glucose Cotransporter 2 Inhibitors for the Treatment of Patients With Heart Failure Importance: Only 1 class of glucose-lowering agents-sodium-glucose cotransporter 2 (SGLT2) inhibitors-has been reported to decrease the risk of cardiovascular events primarily by reducingSeptember 1, 2017: JAMA CardiologyAssociations of albuminuria in patients with chronic heart failure: findings in the ALiskiren Observation of heart Failure Treatment study.CONCLUSIONS: Increased UACR is common in patients with heart failure, including non-diabetics. Urinary albumin creatininineJul, 2011: European Journal of Heart FailureRandomized Controlled TrialEffects of Liraglutide on Clinical Stability Among Patients With Advanced Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial.Review

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

Read by QxMD is copyright © 2021 QxMD Software Inc. All rights reserved. By using this service, you agree to our terms of use and privacy policy.

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app