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자료유형
학술저널
저자정보
Spampinato Michele Domenico (Department of Translational Medicine University of Ferrara Ferrara Italy) Covino Marcello (Department of Emergency Medicine Gemelli University Hospital Catholic University of the Sacred Heart of Rome Rome Italy) Passaro Angelina (Department of Translational Medicine University of Ferrara Ferrara Italy) Benedetto Marcello (Department of Translational Medicine University of Ferrara Ferrara Italy) D’Angelo Luca (Department of Translational Medicine University of Ferrara Ferrara Italy) Galizia Giorgio (Department of Translational Medicine University of Ferrara Ferrara Italy) Fabbri Irma Sofia (Department of Translational Medicine University of Ferrara Ferrara Italy) Pagano Teresa (Department of Translational Medicine University of Ferrara Ferrara Italy) Portoraro Andrea (Department of Translational Medicine University of Ferrara Ferrara Italy) Guarino Matteo (Department of Translational Medicine University of Ferrara Ferrara Italy) Previati Rita (Department of Emergency Medicine St. Anna Hospital Ferrara Italy) Tullo Gianluca (Department of Emergency Medicine Gemelli University Hospital Catholic University of the Sacred Heart of Rome Rome Italy) Gasbarrini Antonio (Department of Internal Medicine Gemelli University Hospital Catholic University of the Sacred Heart of Rome Rome Italy) Giorgio Roberto De (Department of Translational Medicine University of Ferrara Ferrara Italy) Franceschi Francesco (Department of Emergency Medicine Gemelli University Hospital Catholic University of the Sacred Heart of Rome Rome Italy)
저널정보
대한응급의학회 Clinical and Experimental Emergency Medicine Clinical and Experimental Emergency Medicine Vol.10 No.1
발행연도
2023.3
수록면
26 - 36 (11page)
DOI
10.15441/ceem.22.369

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Objective: According to the 2019 European Society of Cardiology (ESC) guidelines on pulmonary embolism (PE), prognosis is calculated using the Pulmonary Embolism Severity Index (PESI), a complex score with debated validity, or simplified PESI (sPESI). We have developed and validated a new risk score for in-hospital mortality (IHM) of patients with PE in the emergency department. Methods: This retrospective, dual-center cohort study was conducted in the emergency departments of two third-level university hospitals. Patients aged >18 years with a contrast-enhanced computed tomography-confirmed PE were included. Clinical variables and laboratory tests were evaluated blindly to IHM. Multivariable logistic regression was performed to identify the new score’s predictors, and the new score was compared with the PESI, sPESI, and shock index. Results: A total of 1,358 patients were included in this study: 586 in the derivation cohort and 772 in the validation cohort, with a global 10.6% of IHM. The PATHOS scores were developed using independent variables to predict mortality: platelet count, age, troponin, heart rate, oxygenation, and systolic blood pressure. The PATHOS score showed good calibration and high discrimination, with an area under the receiver operating characteristics curve of 0.83 (95% confidence interval [CI], 0.77–0.89) in the derivation population and 0.74 (95% CI, 0.68–0.80) in the validation cohort, which is significantly higher than the PESI, sPESI, and shock index in both cohorts (P<0.01 for all comparisons). Conclusion: PATHOS is a simple and effective prognostic score for predicting IHM in patients with PE in an emergency setting.

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