ArticleJournal of intensive care medicine2024
Predicting Hospital Survival in Patients Admitted to ICU with Pulmonary Embolism.
Article in Journal of intensive care medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed.
- Impact of Associated Infections on the Clinical Course and Risk-Stratification Profile of Pulmonary Embolism: Comparative Analysis Using PESI, Wells, Padua, and IMPROVE Scores.Diagnostics (Basel, Switzerland) · 2026Article
- [Modern therapy of pulmonary embolism with PERT and EKOS: an advantage also for in-hospital time?]Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Article
- Comparative analysis of clinical decision tools for acute pulmonary embolism at a tertiary care center.Bioinformation · 2026Article
- Developing and validating a lactate-to-albumin ratio-enhanced score for mortality prediction in ICU patients with acute pulmonary embolism: a multi-cohort study.Frontiers in medicine · 2026Article
- Prediction of mortality in patients with secondary pulmonary embolism based on primary admission indication: A short communication.Biomolecules & biomedicine · 2024Article
- Validity of mortality risk prediction scores in critically ill patients with secondary pulmonary embolism.Biomolecules & biomedicine · 2024Article
- Machine Learning-Based Prediction of Pulmonary Embolism Prognosis Using Nutritional and Inflammatory Indices.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
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Authors and funding
7 authors.
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Abstract
objectiveThe Pulmonary Embolism Severity Index (PESI) and simplified PESI (sPESI) predict mortality for patients with PE. We compared PESI/sPESI to the Acute Physiology and Chronic Health Evaluation IV (APACHE-IV) in predicting mortality in patients with PE admitted to the intensive care unit (ICU). Additionally, we assessed the performance of a novel ICU-sPESI score created by adding three clinical variables associated with acuity of PE presentation (intubation, confusion [altered mental status], use of vasoactive infusions) to sPESI. MATERIALS AND
methodsUsing the eICU Collaborative Research Database from 2014 to 2015, we conducted a large retrospective cohort study of adult patients admitted to the ICU with a primary diagnosis of PE. We calculated APACHE-IV, PESI, sPESI, and ICU-sPESI scores and compared their performance for predicting in-hospital mortality using area under the receiver operating characteristic (AUROC) curve. Score thresholds for >99% negative predictive values (NPV) were calculated for each score. Survival was estimated using the Kaplan-Meier method.
resultsWe included 1424 PE cases. In-hospital mortality was 6.3% [95% CI: 5.1%-7.6%]. AUROC for APACHE-IV, PESI, and sPESI were 0.870, 0.848, and 0.777, respectively. APACHE-IV and PESI outperformed sPESI (P < 0.01 for both comparisons), while APACHE-IV and PESI demonstrated similar performance (P = 0.322). The ICU-sPESI performance was similar to APACHE-IV and PESI (AUROC = 0.847; AUROC comparison: APACHE-IV vs ICU-sPESI: P = 0.396; PESI vs ICU-sPESI: P = 0.945). Hospital mortality for ICU-sPESI scores 0-2 was 1.1%, and for scores 3, 4, 5, 6, and ≥7 was 8.6%, 11.7%, 29.2%, 37.5%, and 76.9%, respectively. Score thresholds for >99% NPV were ≤48 for APACHE-IV, ≤115 for PESI, and 0 points for sPESI and ICU-sPESI.
conclusionsBy accounting for severity of PE presentation, our newly proposed ICU-sPESI score provided improved PE mortality prediction compared to the original sPESI score and offered excellent discrimination of mortality risk.
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