Bircan et al developed a model for identifying a patient with severe pulmonary embolism. This combines the ECG score of Daniel at al, the shock index and arterial blood gas results. The authors are from Suleyman Demirel University in Isparta, Turkey.
Parameters:
(1) ECG score of Daniel et al (see 07.13.03)
(2) shock index (SI)
(3) arterial blood gas findings (PaO2 and PaCO2, hypoxemia and hypocapnia)
The ECG score ranges from 0 to 21.
shock index = SI =
= (heart rate in beats per minute) / (systolic blood pressure in mm Hg)
|
Shock Index |
Points |
|
< 1 |
0 |
|
>= 1 |
1 |
A score of 1 for SI is seen in patients with a high mortality rate.
|
Parameter |
Finding |
Points |
|
PaO2 |
< 48.8 mm Hg |
4 |
|
|
48.8 to 59.9 mm Hg |
3 |
|
|
60 to 71.2 mm Hg |
2 |
|
|
71.3 to 82.4 mm Hg |
1 |
|
|
> 82.4 mm Hg |
0 |
|
PaCO2 |
< 36 mm Hg |
2 |
|
|
36 to 38 mm Hg |
1 |
|
|
> 38 mm Hg |
0 |
total score =
= (points for ECG) + (points for SI) + (points for arterial blood gases)
Interpretation:
• minimum score: 0
• maximum score: 28
|
Score |
Percent Showing Severe PE |
Rate Right Ventricular Dysfunction |
|
0 to 9 |
36% |
50% |
|
10 to 13 |
50% |
70% |
|
14 to 28 |
80% |
87% |
Specialty: Cardiology, Pulmonology
