Abstract 14648: Can GRACE Risk Score Predict Mortality in Pulmonary Embolism?

Abstract

Introduction Risk stratifying of pulmonary embolism (PE) patients and treatment for normotensive patients is still challenging. We aimed to assess the utility of GRACE risk score for 30-day mortality. Methods All consecutive patients hospitalized with a diagnosis of PE between2016 -2021 were included in this retrospective study. GRACE and PESI scores were calculated online. Results A total of 197 patients were enrolled. Mean age was 63.98±15.51. 56 of patients died by the end of the 30-day. When patients divided into 2 groups according to 30-day mortality, both groups were similar in terms of gender, hypertension, diabetes mellitus, coronary artery disease, heart failure and chronic obstructive pulmonary disease. Troponin level (212.4± 24.6 vs. 850.8±231.1; p<0.0001), PESI (122.3±27.2 vs. 170.1±49.1; p<0.0001) and GRACE (127.1±28.8 vs. 182±21.3; p<0.0001) were significantly higher in non-survivor group. The correlation analysis we observed strong positive correlation between PESİ and GRACE (r=0.732; p<0.0001). Regression analysis revealed that only GRACE score [p=0.021, β: 1.146, OR (95% CI): 1.021-1.286] was an independent risk factor associated with 30-day mortality. ROC curve for accuracy of GRACE score for predicting 30-day mortality in PE patients is shown in figure 1. Area under curve (AUC) for GRACE score was 0.969 [%95 CI: 0.948-0.990]. A cut off value of 161.5 for GRACE score was associated with 90.0% sensitivity and 89.7% specificity in prediction of 30-day mortality. Conclusion In this study, the relation between GRACE score and the clinical course of PE patients evaluated and we found GRACE risk score as an independent risk factor associated with 30-day mortality and strong correlation between GRACE and PESİ risk scores. To predict the mortality of high-risk normotensive and hypotensive PE patients,GRACE risk score exhibited high specificity and positive probability.