Angriman et al reported 2 simple scores for evaluating a patient with an acute pulmonary embolism. These can identify a patient who is at low risk for adverse outcomes in the following 14 days. The authors are from Harvard University, Hospital Italiano de Buenos Aires, Centre Hospitalo-Universitaire d'Angers and the University of Ottawa.
Patient selection: acute pulmonary embolism
Outcome: all-cause mortality, recurrent embolism, or major bleeding within 14 days
Parameters:
(1) age in years
(2) oxygen requirement
(3) requirement for intravenous drugs (analgesia, unfractionated heparin, etc)
(4) malignancy (active or prior)
(5) hypotension (systolic blood pressure < 90 mm Hg)
|
Parameter
|
Findings
|
Score 1
|
Score 2
|
|
age in years
|
< 55
|
0
|
0
|
|
|
55 to 65
|
1
|
0
|
|
|
> 65
|
1
|
1
|
|
oxygen requirement
|
no
|
0
|
0
|
|
|
yes
|
4
|
1
|
|
IV requirement
|
no
|
0
|
0
|
|
|
yes
|
6
|
1
|
|
malignancy
|
no
|
0
|
0
|
|
|
yes
|
5
|
1
|
|
hypotension
|
no
|
0
|
0
|
|
|
|
4
|
1
|
score 1 =
= SUM(points for score 1 parameters)
score 2 =
= SUM(points for score 2 parameters)
Interpretation:
• minimum scores: 0
• maximum score 1: 20
• maximum score 2: 5
• A score 1 < 4 is associated with a low risk of an adverse outcome.
• A score 2 < 1 is associated with a low risk of an adverse outcome.
Performance:
• The area under the ROC curve for score 1 is 0.79.
• The area under the ROC curve for score 2 is 0.77.
