ArticleJournal of the American College of Emergency Physicians open2023
Comparing predictive performance of pulmonary embolism risk stratification tools for acute clinical deterioration.
Article in Journal of the American College of Emergency Physicians open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Predictive modeling for mortality risk in elderly patients with pulmonary embolism using machine learning algorithms.Frontiers in medicine · 2026Article
- A nomogram integrating CTPA parameters and serum biomarkers to predict 30-day mortality and refine risk stratification in non-high-risk acute pulmonary embolism.Frontiers in cardiovascular medicine · 2026Article
- Echocardiography-Based Pulmonary Artery Pulsatility Index Correlates with Outcomes in Patients with Acute Pulmonary Embolism.Journal of clinical medicine · 2025Article
- Current Role of CT Pulmonary Angiography in Pulmonary Embolism: A State-of-the-Art Review.Journal of imaging · 2024Review
- Addressing the rising trend of high-risk pulmonary embolism mortality: Clinical and research priorities.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2024Article
- Comparing predictive performance of pulmonary embolism risk stratification tools for acute clinical deterioration.Journal of the American College of Emergency Physicians open · 2023Article
Corrections and comments
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Authors and funding
16 authors.
Funding
Abstract
Objectives: Existing pulmonary embolism (PE) risk scores were developed to predict death within weeks, but not more proximate adverse events. We determined the ability of 3 PE risk stratification tools (simplified pulmonary embolism severity index [sPESI], 2019 European Society of Cardiology guidelines [ESC], and PE short-term clinical outcomes risk estimation [PE-SCORE]) to predict 5-day clinical deterioration after emergency department (ED) diagnosis of PE. Methods: We analyzed data from six EDs on ED patients with confirmed PE. Clinical deterioration was defined as death, respiratory failure, cardiac arrest, new dysrhythmia, sustained hypotension requiring vasopressors or volume resuscitation, or escalated intervention within 5 days of PE diagnosis. We determined sensitivity and specificity of sPESI, ESC, and PE-SCORE for predicting clinical deterioration. Results: Of 1569 patients, 24.5% had clinical deterioration within 5 days. sPESI, ESC, and PE-SCORE classifications were low-risk in 558 (35.6%), 167 (10.6%), and 309 (19.6%), respectively. Sensitivities of sPESI, ESC, and PE-SCORE for clinical deterioration were 81.8 (78, 85.7), 98.7 (97.6, 99.8), and 96.1 (94.2, 98), respectively. Specificities of sPESI, ESC, and PE-SCORE for clinical deterioration were 41.2 (38.4, 44), 13.7 (11.7, 15.6), and 24.8 (22.4, 27.3). Areas under the curve were 61.5 (59.1, 63.9), 56.2 (55.1, 57.3), and 60.5 (58.9, 62.0). Negative predictive values were 87.5 (84.7, 90.2), 97 (94.4, 99.6), and 95.1 (92.7, 97.5). Conclusions: ESC and PE-SCORE were better than sPESI for detecting clinical deterioration within 5 days after PE diagnosis.
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