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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.
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https://hal.univ-brest.fr/hal-00790074
Contributor : Ghislaine Calvez <>
Submitted on : Tuesday, February 19, 2013 - 1:37:16 PM
Last modification on : Tuesday, October 13, 2020 - 3:46:08 PM

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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⟩

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