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논문 기본 정보

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학술저널
저자정보
Kajal Patel (Department of Emergency Medicine Western Health) Sharon Klim (Joseph Epstein Centre for Emergency Medicine Research Western Health) Peter Ritchie (Department of Emergency Medicine Western Health) Ieuan Johns (Department of Emergency Medicine Western Health) Anne-Maree Kelly (Joseph Epstein Centre for Emergency Medicine Research Western Health)
저널정보
대한응급의학회 Clinical and Experimental Emergency Medicine Clinical and Experimental Emergency Medicine Vol.7 No.2
발행연도
2020.1
수록면
107 - 113 (7page)

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Objective Recently, a novel score for risk stratification of patients with pulmonary embolism (PE)—the HOPPE score—was derived. We aimed to externally validate the HOPPE score in emergency department-diagnosed PE, using SpO2 as a surrogate for PaO2—the modified HOPPE score. Methods Retrospective observational study of adult patients with an emergency department diagnosis of PE was performed. Data collected included demographics, co-morbidities, clinical features, electrocardiogram and test results, in-hospital mortality and non-fatal major adverse clinical events (MACE; survived cardiac arrest, cardiogenic shock or thrombolysis administration). The primary outcome of interest was clinical performance of the modified HOPPE score for in-hospital mortality and the composite outcome of in-hospital death and MACE. A secondary outcome was comparison of predictive performance between the modified HOPPE score and the simplified Pulmonary Embolism Severity Index score. Results Two hundred and six patients were studied (median age 61, 55% female). There were no deaths or MACE in patients with a low risk modified HOPPE score of 0 to 6 (0%; 95% confidence interval, 0% to 1.8%). Negative predictive value of a low risk score was 100% (95% confidence interval, 92.2% to 100%) for in-hospital mortality and for the composite of in-hospital mortality or MACE. The modified HOPPE score had similar predictive performance to the simplified Pulmonary Embolism Severity Index score with an area under the curve of 0.88 vs. 0.80 for the composite outcome of in-hospital mortality or MACE (P=0.052). Twenty-eight percent of the patients were classified as low risk and potentially suitable for management as outpatients. Conclusion The modified HOPPE score showed good clinical performance. Prospective validation is warranted.
#Pulmonary embolism #Emergency service #hospital #Risk assessment #Methods

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참고문헌 (13)

참고문헌 신청
Kelly AM / 2017 / An observational study of dyspnea in emergency departments: the Asia, Australia, and New Zealand Dyspnea in Emergency Departments Study (AANZDEM) / Acad Emerg Med 24:328~336 google schola Subramanian M / 2017 / Derivation and validation of a novel prediction model to identify low-risk patients with acute pulmonary embolism / Am J Cardiol 120:676~681 google schola Roy PM / 2017 / Outpatient management of pulmonary embolism / Thromb Res 155:92~100 google schola Kabrhel C / 2019 / Multicenter implementation of a novel management protocol increases the outpatient treatment of pulmonary embolism and deep vein thrombosis / Acad Emerg Med 26:657~669 google schola Erkens PM / 2012 / Does the Pulmonary Embolism Severity Index accurately identify low risk patients eligible for outpatient treatment / Thromb Res 129:710~714 google schola

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