Comparison of geriatric pulmonary embolism severity index (G-PESI) with PESI and s-PESI in predicting prognosis and mortality

Abstract

Aim: Our objective is to investigate the effect of geriatric pulmonary embolism severity index score on mortality independent of age and to compare it with pulmonary embolism severity index and simplified pulmonary embolism severity index. Material and Method: This is a retrospective observational study including patients over 65 years of age diagnosed with pulmonary embolism, who presented to the emergency medicine clinic of tertiary hospital between January 1, 2016 and January 1, 2021. The relationship between the original PESI and 30-day mortality was evaluated, and age was removed from the original score in the G-PESI. A univariate analysis of PESI, s-PESI, and G-PESI was performed using the chi-square test, Fisher’s exact test, Student’s t-test, and Mann–Whitney U test as appropriate to determine the association of these scores with 30-day mortality. Statistical analysis was performed using SPSS version 26.0. Results: This study included 167 patients, of whom 113 (67.7%) were women. According to the diagnostic test performance analysis report, the pulmonary embolism severity index, simplified pulmonary embolism severity index and geriatric pulmonary embolism severity index scores were statistically significant in predicting mortality, with the area under the curve values of 0.736 (0.34-1.91), 0.635 (0.74-1.81), and 0.739 (0.50-2.18) at the cut-off values of >110, >2, and >40, respectively (p<0.001, p<0.001, and p=0.004 respectively). When the area under the curve values of these three scores were compared, there was no statistically significant difference between pulmonary embolism severity index and geriatric pulmonary embolism severity index (p=0.7241). Discussion: Geriatric pulmonary embolism severity index, similar to pulmonary embolism severity index, can be accepted as an independent predictor in geriatric patients diagnosed with pulmonary embolism.

Keywords

• geriatrics,
• PESI
• pulmonary embolism

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