The Anatolian Journal of Cardiology
- Epidemiology

Performance of pulmonary embolism severity index in predicting long-term mortality after acute pulmonary embolism

1.

Ankara Mesleki ve Çevresel Hastalıklar Hastanesi, Meslek Hastalıkları Kliniği, Ankara

2.

Ankara Üniversitesi Tıp Fakültesi, İmmünoloji ve Allerji Hastalıkları Bilim Dalı, Ankara

3.

Ankara Keçiören Sanatoryum Atatürk Göğüs Hastalıkları ve Göğüs Cerrahisi Eğitim ve Araştırma Hastanesi, Uyku Ünitesi, Ankara

4.

Hacettepe Üniversitesi Tıp Fakültesi, Göğüs Hastalıkları Ana Bilim Dalı, Ankara

5.

Özel Medicana Kadıköy Hastanesi, Göğüs Hastalıkları Kliniği, İstanbul

Anatol J Cardiol 2021; -1: 0-0
Read: 176 Published: 01 July 2021

Objective: We aimed to evaluate the accuracy of the original and simplified Pulmonary Embolism (PE) Severity Index (PESI) to predict all-cause mortality after 30 days of acute PE diagnosis up to five years within consecutive sub-periods. Methods: Adult patients diagnosed with acute PE between January 1, 2003, and June 30, 2013, were retrospectively included. Data on baseline characteristics and mortality during a 5-year follow-up were collected. Results: The study included 414 patients (M/F=192/222). The median age at diagnosis was 61.5 (minimum-maximum, 18-93) years. Mortality rates were 13.3% at 30-d, 21.8% at 90-d, 32.6% at 1-year, and 51.0% at 5-year. Both stratification into risk classes according to the original PESI and low- vs. high-risk classification of original and simplified PESI were significantly correlated with 30-d, 31-90-d, 91-d-1-year, and 1-5-year mortality. Significant PESI predictors for mortality were history of cancer (HR=3.31, CI95%: 1.64-6.68; p=0.001) and heart failure (HR=2.35, CI95%: 1.04-5.32, p=0.041) at 31-90-d, history of cancer (HR=5.45, CI95%: 2.86-10.40, p<0.001) at 91-d-1-year, advancing age (HR=1.04, CI95%: 1.02-1.06, p<0.001) and history of cancer (HR=5.53, CI95%: 3.41-8.98, p<0.001) at 1-5-year after acute PE diagnosis. Conclusion: All-cause long-term mortality in high-risk acute PE patients according to original or simplified PESI significantly increased up to five years of follow-up. This survival disadvantage was mainly related to cancer and comorbidities rather than acute clinical manifestations. Future prospective studies are needed to demonstrate the effect of various comorbidities on long-term mortality in these patients.

ISSN 2149-2263 EISSN 2149-2271