Bova et al developed a risk score for evaluating patients with pulmonary emboli. This can help to identify a patient at risk for complications within 30 days of the event. The authors are from multiple institutions in Europe.
Patient selection: pulmonary embolism (PE)
Outcome: PE-related complications (death, hemodynamic collapse, recurrent nonfatal PE) within 30 days
Parameters:
(1) systolic blood pressure in mm Hg
(2) serum cardiac troponin concentration
(3) right venticular dysfunction (on CT scan or echocardiography, with right to left ventricle ratio > 1)
(4) heart rate in beats per minute
Parameter
Finding
Points
systolic blood pressure
> 100 or < 90 mm Hg
0
90 to 100 mm Hg
2
serum cardiac troponin
normal
0
elevated
2
right ventricular dysfunction
absent
0
present
2
heart rate
< 110 beats per minute
0
>= 110 beats per minute
1
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
• The higher the score the greater the risk for complications.
Total Score
Stage
30-Day PE Complications
0 to 2
I
4.2%
3 or 4
II
10.8%
5 to 7
III
29.2%
Performance:
• The area under the ROC curve was 0.73.
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