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

Yıl 2022, Cilt: 5 Sayı: 2, 676 - 681, 15.03.2022

Hatice Şeyma Akça , Serdar Özdemir , Abdullah Algın , İbrahim Altunok

https://doi.org/10.32322/jhsm.1070588

Cited By: 3

Öz

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.

Anahtar Kelimeler

geriatrics,, PESI, pulmonary embolism

Kaynakça

• Roy PM, Douillet D, Penaloza A. Contemporary management of acute pulmonary embolism. Trends Cardiovasc Med 2021; 29; S1050-1738(21)00068-2.
• den Exter PL, van Es J, Erkens PM, et al. Impact of delay in clinical presentation on the diagnostic management and prognosis of patients with suspected pulmonary embolism. Am J Respir Crit Care Med 2013; 187: 1369-73.
• Le Gal G, Righini M, Roy PM, et al. Differential value of risk factors and clinical signs for diagnosing pulmonary embolism according to age. J Thromb Haemost 2005; 3: 2457-64.
• Meguid El Nahas A, Bello AK. Chronic kidney disease: the global challenge. Lancet 2005; 365: 331-40.
• Robert-Ebadi H, Righini M. Diagnosis and management of pulmonary embolism in the elderly. Eur J Int Med 2014; 25: 343-9.
• Aujesky D, Obrosky DS, Stone RA, et al. Derivation and validation of a prognostic model for pulmonary embolism. Am J Respir Crit Care Med 2005; 172: 1041-6.
• Jiménez D, Aujesky D, Moores L, et al. Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism. Arch Intern Med 2010; 170: 1383-9.
• Ostovan MA, Ghaffari S, Pourafkari L, et al. Modification of simplified pulmonary embolism severity index and its prognostic value in patients with acute pulmonary embolism. Heart Lung Circulation 2016; 25: 184-90.
• Hanley JA, McNeil BJ. The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology 1982; 143: 29-36.
• Hanley JA, McNeil BJ. A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology 1983; 148: 839-43.
• Deeks JJ. Systematic reviews of evaluations of diagnostic and screening tests. In:Egger M Davey Smith G Altman DG (Eds). Systematic reviews in health care: meta-analysis in context. Systematic reviews. 2nd edition, BMJ Books London 2001, pp 248-82.
• Price CP, Newall RG, Boyd JC. Use of protein: creatinine ratio measurements on random urine samples for prediction of significant proteinuria: a systematic review. Clin Chem 2005; 51: 1577-86.
• Fischer JE, Bachmann LM, Jaeschke R. A readers' guide to the interpretation of diagnostic test properties: clinical example of sepsis. Intensive Care Med 2003; 29: 1043-51.
• Yamashita Y, Morimoto T, Amano H, et al. Validation of simplified PESI score for identification of low-risk patients with pulmonary embolism: From the COMMAND VTE Registry. Eur Heart J: Acute Cardiovasc Care 2020; 9: 262-70.
• Jaquet E, Tritschler T,  Stalder O, et al. Prediction of short-term prognosis in elderly patients with acute pulmonary embolism: validation of the RIETE score. J Thromb Haemost 2018; 16: 1313-20.
• Zwierzina D,  Limacher A, Méan M, et al. Prospective comparison of clinical prognostic scores in elder patients with a pulmonary embolism. J Thromb Haemost 2012; 10: 2270-6.