Prognostic Ability of Simplified Pulmonary Embolism Severity Index (PESI) Score in Real World: A Brief Report

Abstract

Background and aim: Prognostic stratification of acute pulmonary embolism (PE) represents the cornerstone of modern management of this potentially life-threatening disease. In the latest years, a lot of clinical prognostic models have been validated. However, these are yet underused in clinical practice, especially in real world populations. The aim of our study was to test the prognostic ability of the Simplified Pulmonary Embolism Severity Index (sPESI) score in a real world population. Methods: Data records of 452 patients that were discharged for acute PE from 28 Internal Medicine wards of Tuscany (Italy) were retrospectively analysed. sPESI was calculated in the identical manner as the original study. Prognostic ability of sPESI score for predicting in-hospital all-cause and PE-related mortality was tested by using Areas under Receiver Operating Characteristics (ROC) curve (AUC). Results: 15.2% of patients were classified as sPESI score 0, whereas 84.8% were classified as sPESI ≥ 1. All causes of in-hospital mortality were 10.95% (5.75% PE-related) in patients with sPESI score ≥ 1 and 0% (0% PE-related) in sPESI score 0. AUC for all causes of mortality was 0.694 (95% CI: 0.650-0.736), whereas it was 0.702 (95% CI: 0.657-0.743) for PE-related mortality. Conclusion: In a real world population, sPESI is a good prognosticator for all causes of in-hospital and PE-related mortality and its use should be encouraged.