Echocardiography and PESI have independent prognostic role in pulmonary embolism.

Abstract : We analysed a cohort of patients with normotensive pulmonary embolism (PE) in order to assess whether combining echocardiography and biomarkers with the pulmonary embolism severity index (PESI) improves the risk-stratification in comparison to the PESI alone.The PESI was calculated in normotensive patients with PE who also underwent echocardiography and assays of troponin and brain natriuretic peptide. Thirty-day adverse outcome was defined as death, recurrent PE or shock.529 patients were included, 25 (4.7%; 95% confidence interval (CI), 3.2% to 6.9%) had at least one outcome event. The proportion of patients with adverse events increased from 2.1% in PESI class I-II to 8.4% in PESI class III-IV, and to 14.3% in PESI class V (P<0.001). In PESI class I-II, the rate of outcome events was significantly higher in patients with abnormal values of biomarkers or right ventricular (RV) dilatation. In multivariate analysis, the PESI (Odds Ratio (OR) III-IV versus I-II: 3.1; 95%CI, 1.2-8.3; OR V versus I-II: 5.5; 95%CI, 1.5-25.5) and echocardiography (RV/left ventricular ratio, OR for an increase of 0.1: 1.3; 95%CI, 1.1-1.5) were independent predictors of an adverse outcome.In patients with normotensive PE, biomarkers and echocardiography provided additional prognostic information to the PESI.
Type de document :
Article dans une revue
European Respiratory Journal, European Respiratory Society, 2012, epub ahead of print. 〈10.1183/09031936.00097512〉
Liste complète des métadonnées

http://hal.univ-brest.fr/hal-00790074
Contributeur : Ghislaine Calvez <>
Soumis le : mardi 19 février 2013 - 13:37:16
Dernière modification le : mercredi 10 janvier 2018 - 14:42:02

Lien texte intégral

Identifiants

Collections

Citation

Olivier Sanchez, Ludovic Trinquart, Benjamin Planquette, Francis Couturaud, Franck Verschuren, et al.. Echocardiography and PESI have independent prognostic role in pulmonary embolism.. European Respiratory Journal, European Respiratory Society, 2012, epub ahead of print. 〈10.1183/09031936.00097512〉. 〈hal-00790074〉

Partager

Métriques

Consultations de la notice

159