The Pulmonary Embolism Severity Index in Predicting the Prognosis of Patients With Pulmonary Embolism
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background/Aims: Many prognostic models have been developed to help physicians make medical decisions on treating patients with pulmonary embolism. Among these models, the Pulmonary Embolism Severity Index (PESI) has been shown to be a successful risk stratification tool for patients with acute pulmonary embolism. The PESI, however, had not been applied to patients with pulmonary embolism in Korea. Methods: The patients included in this study were diagnosed by computed tomography at Inje University’s Ilsan Paik Hospital between December 1999 and March 2007. Risk stratification for the patients was performed using the PESI. The mortality rate was calculated according to each PESI risk class. Results: Of the 90 patients enrolled in this study, ten were assigned to PESI class I, 29 to PESI class II, 22 to PESI class III, eight to PESI class IV, and ten to PESI class V. The mortality rate after 30 days in each class was 0, 10.3, 9.1, 0, and 50% (p=0.0016), respectively, whereas the respective hospital mortality rate was 4.8, 13.8, 13.6, 12.5, and 50% (p=0.0065). The overall mortality was 9.5, 27.6, 31.8, 50.0, and 60%, respectively (p=0.0019). The mortality rate was significantly associated with the PESI class. Conclusions: The PESI class was found to be significantly correlated with the 30-day mortality rate, hospital mortality, and overall mortality. Our data indicate that the PESI can be used to predict the prognosis of patients with pulmonary embolism and in making medical decisions regarding the treatment of patients with pulmonary embolism.
Abstract
Background/Aims: Many prognostic models have been developed to help physicians make medical decisions on treating patients with pulmonary embolism. Among these models, the Pulmonary Embolism Severity Index (PESI) has been shown to be a successful risk stratification tool for patients with acute pulmonary embolism. The PESI, however, had not been applied to patients with pulmonary embolism in Korea. Methods: The patients included in this study were diagnosed by computed tomography at Inje University’s Ilsan Paik Hospital between December 1999 and March 2007. Risk stratification for the patients was performed using the PESI. The mortality rate was calculated according to each PESI risk class. Results: Of the 90 patients enrolled in this study, ten were assigned to PESI class I, 29 to PESI class II, 22 to PESI class III, eight to PESI class IV, and ten to PESI class V. The mortality rate after 30 days in each class was 0, 10.3, 9.1, 0, and 50% (p=0.0016), respectively, whereas the respective hospital mortality rate was 4.8, 13.8, 13.6, 12.5, and 50% (p=0.0065). The overall mortality was 9.5, 27.6, 31.8, 50.0, and 60%, respectively (p=0.0019). The mortality rate was significantly associated with the PESI class. Conclusions: The PESI class was found to be significantly correlated with the 30-day mortality rate, hospital mortality, and overall mortality. Our data indicate that the PESI can be used to predict the prognosis of patients with pulmonary embolism and in making medical decisions regarding the treatment of patients with pulmonary embolism.
참고문헌 (10)
- Anderson FA Jr, "A populationbased perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism", Arch Intern Med, 151, pp.933~938 (1991)
- Wicki J, "Predicting adverse outcome in patients with acute pulmonary embolism: a risk score", Thromb Haemost, 84, pp.548~552 (2000)
- Aujesky D, "Derivation and validation of a prognostic model for pulmonary embolism", Am J Respir Crit Care Med, 172, pp.1041~1046 (2005)
- Jimenez D, "Prognostic models for selecting patients with acute pulmonary embolism for initial outpatient therapy", Chest, 132, pp.24~30 (2007)
- Lee S, "Int J Cardiol", 108, pp.84~88 (2006)
- Bak SM, "Clinical study of pulmonary thromboembolism", Tuberc Respir Dis, 50, pp.106~116 (2001)
- Buller HR, "Subcutaneous fondaparinux versus intravenous unfractionated heparin in the initial treatment of pulmonary embolism", N Engl J Med, 349, pp.1695~1702 (2003)
- Kurkciyan I, "Pulmonary embolism as a cause of cardiac arrest: presentation and outcome", Arch Intern Med, 160, pp.1529~1535 (2000)
- Simonneau G, "A comparison of lowmolecular- weight heparin with unfractionated heparin for acute pulmonary embolism: the THESEE (Tinzaparine ou Heparine Standard: Evaluations dans l’Embolie Pulmonaire) Study Group", N Engl J Med, 337, pp.663~669 (1997)
- Nendaz MR, "Validation of a risk score identifying patients with acute pulmonary embolism, who are at low risk of clinical adverse outcome", Thromb Haemost, 91, pp.1232~1236 (2004)
