Forecast value of combination of troponin I and pulmonary embolism severity index for severity in patients with pulmonary embolism

Abstract

Objective To study the forecast value of combination of troponin I and pulmonary embolism severity index for severity in patients with pulmonary embolism （PE）. Methods The data of 245 patients with PE confirmed in the First Hospital of Shanxi Medical University. According to PESI, level of troponin I and combination of troponin I and PESI, the patients were divided into different groups. The incidence rates of non-massive, massive and sub-massive PE patients were compared. The forecast value of the PESI score,the level of troponin I and combination of troponin I and PESI for the severity in PE patients were evaluated. Results In the PESI classification, both class I and class II （low-risk group） were non-massive PE. In the class UI （intermediate-risk group） ,the non-massive PE accounted for 42.5% the massive and sub-massive PE accounted for 57.5%. The massive and sub-massive PE in the class IV and class V （high-risk group） respectively accounted for 92.5% and 100.0%. The positive predictive value （PPV） and specificity were respectively 96.9 %, 95.2 % in the high-risk group, while both the negative predictive value （NPV） and sensitivity were 100.0% in the low-risk group. The incidence rate of massive and sub-massive PE,PPV and specificity were respectively 98.2% ,98.2% and 36.5% in the group of negative troponin I, but incidence rate of non-massive PE, NPV and sensitivity were respectively 94.1%, 94.1% and 48.0%. The incidence rate of massive and sub-massive PE, PPV and specificity were respectively 94.1%, 94.1% and 94.3% in the combination of positive troponin I and intermediate-risk group. Conclusions The high-risk group has a higher predictive value for severity of massive and sub-massive PE. It has less predictive value for the severity of PE to use the level of troponin I than the combination of troponin I and PESI. Key words: Acute pulmonary embolism; Pulmonary embolism severity index; Troponin I