Ozsu et al reporting a staging system for patients with pulmonary embolism who are normotensive. This can help to identify a patient who may benefit from more aggressive management. The authors are from Karadeniz Technical University in Trabzon, Turkey.
Patient selection: pulmonary embolism and normotensive (systolic blood pressure 110 to 130 mm Hg)
Parameters:
(1) serum troponin T concentration: either troponin T or high sensitivity troponin T. The cutoffs were < 0.010 ng/mL for troponin and < 0.014 ng/mL for high sensitivity troponin T. A value above the cutoff is considered abnormal.
(2) shock index
shock index =
= (heart rate in beats per minute) / (systolic blood pressure in mm Hg)
Parameter
Finding
Points
serum troponin
normal
0
elevated
2
shock index
< 1
0
>= 1
1
total score =
= SUM(points for serum troponin) + (points for shock index)
Interpretation:
• minimum score: 0
• maximum score: 3
Score
Risk Group
Stage
30 Day Mortality
0 or 1
low
I
4.3%
2
intermediate low
II
19%
3
intermediate high
III
39%
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