Prognostic Factors of Jimenez et al for a Normotensive Patient with Acute Pulmonary Embolism

Description

Jimenez et al identified prognostic factors for a normotensive patient with acute symptomatic pulmonary embolism (PE). These can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in Europe and the United States.

Patient selection: normotensive patient with acute pulmonary embolism

Outcome: 30-day complicated outcome (all-cause mortality, hemodynamic collapse, recurrent PE)

Parameters:

(1) serum troponin I in ng/mL

(2) serum BNP in pg/mL

(3) deep vein thrombosis (DVT) on complete lower limb ultrasonography

(4) simplified PESI (sPESI, from 0 to 6)

Parameter	Finding	Odds Ratio
serum troponin I	<= 0.05 ng/mL	1
	> 0.05 ng/mL	1.96
serum BNP	<= 100 pg/mL	1
	> 100 pg/mL	2.12
DVT on US	absent	1
	present	2.08
simplified PESI	0 (low risk)	1
	>=1 (high risk)	5.62

From Figure 3

sPESI	BNP	troponin	CCUS	observed
low	<= 100	NA	NA	0.9%
low	> 100	NA	NA	2.8%
high	<= 100	NA	NA	6.1%
high	> 100	<= 0.05	NA	10.9%
high	> 100	> 0.05	absent	17.5%
high	> 100	> 0.05	present	25.8%

If the odds ratios are converted to points (by taking LN and multiplying by 10):

Parameter	Points
serum troponin	7
serum BNP	8
DVT by US	7
sPESI	17

Score	Observed
0 (minimum)	0.9%
7	2.8%
17	6.1%
25	10.9%
32	17.5%
39 (maximum)	25.8%

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Prognostic Factors of Jimenez et al for a Normotensive Patient with Acute Pulmonary Embolism

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