Jen et al reported a score for risk stratification following an acute pulmonary embolism. This can help to identify a patient who may benefit from more aggressive management. The authors are from the National University of Singapore.
Patient selection: acute pulmonary embolism, age > 18 years
Outcome: 30-day all-cause mortality
Parameters:
(1) age in years
(2) heart failure
(3) lung disease
(4) respiratory rate in breaths per minute
(5) mental status
(6) intravenous drug (analgesic, unfractionated heparin, etc) required
(7) serum ALT in IU/L
(8) hemoptysis
Parameter
Finding
Points
age in years
heart failure
no
0
yes
20
lung disease
no
0
yes
25
respiratory rate
<= 30 breaths per min
0
> 30 breaths per min
40
mental status
normal
0
altered (disorientation, lethargy, stupor, coma)
10
IV drugs required
no
0
yes
50
serum ALT
<= 75 IU/L
0
> 75 IU/L
40
hemoptysis
no
0
yes
60
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 19
• maximum score: around 345
• A score > 100 indicates high risk.
Performance:
• The area under the ROC curve is 0.79.
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