Prediction of in-hospital deterioration in normotensive pulmonary embolism remains elusive: external validation of the calgary acute pulmonary embolism score. J Thromb Thrombolysis 2023 Aug;56(2):327-332
Date
06/23/2023Pubmed ID
37351823Pubmed Central ID
PMC10641891DOI
10.1007/s11239-023-02853-3Scopus ID
2-s2.0-85162695417 (requires institutional sign-in at Scopus site)Abstract
Acute pulmonary embolism (PE) is a frequently diagnosed condition. Prediction of in-hospital deterioration is challenging with current risk models. The Calgary Acute Pulmonary Embolism (CAPE) score was recently derived to predict in-hospital adverse PE outcomes but has not yet been externally validated. Retrospective cohort study of normotensive acute pulmonary embolism cases diagnosed in our emergency department between 2017 and 2019. An external validation of the CAPE score was performed in this population for prediction of in-hospital adverse outcomes and a secondary outcome of 30-day all-cause mortality. Performance of the simplified Pulmonary Embolism Severity Index (sPESI) and Bova score was also evaluated. 712 patients met inclusion and exclusion criteria, with 536 patients having a sPESI score of 1 or more. Among this population, the CAPE score had a weak discriminative power to predict in-hospital adverse outcomes, with a calculated c-statistic of 0.57. In this study population, an external validation study found weak discriminative power of the CAPE score to predict in-hospital adverse outcomes among normotensive PE patients. Further efforts are needed to define risk assessment models that can identify normotensive PE patients at risk for in hospital deterioration. Identification of such patients will better guide intensive care utilization and invasive procedural management of PE.
Author List
Hyder SN, Goraya SR, Grace KA, O'Hare C, Schaeffer WJ, Stover M, Matthews T, Khaja MS, Liles A, Greineder CF, Barnes GDAuthor
William J. Schaeffer DO Assistant Professor in the Emergency Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Acute DiseaseHospitals
Humans
Prognosis
Pulmonary Embolism
Retrospective Studies
Risk Assessment
Severity of Illness Index
