Use of simplified Pulmonary Embolism Severity Index in risk stratification of the elderly patients at 80 years and over with non-high-risk pulmonary embolism
Received:November 13, 2019  
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DOI:10.11915/j.issn.1671-5403.2020.09.156
Key words:aged  80 years or over  simplified Pulmonary Embolism Severity Index  risk stratification  prognosis This work was supported by the Priming Scientific Research Foundation for the Junior Researcher in Beijing Tongren Hospital, Capital Medical University
Author NameAffiliationE-mail
HOU Yin-Jing Department of Geriatrics, Beijing Tongren Hospital, Beijing 100070, China qinmingzhao58@163.comuse 
CHEN Lu Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China qinmingzhao58@163.comuse 
QIN Ming-Zhao Department of Geriatrics, Beijing Tongren Hospital, Beijing 100070, China qinmingzhao58@163.comuse 
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Abstract:
      Objective To explore the value of simplified Pulmonary Embolism Severity Index (sPESI) in the risk stratification in the patients aged 80 years or over with non-high risk pulmonary embolism (PE). Methods A total of 141 patients with non-high-risk PE hospitalized in Beijing Tongren Hospital in the last eight years were divided into low-risk group (n=53), middle-low-risk group (n=75) and middle-high-risk group (n=13). The patients were assessed using PESI, sPESI, Bova score, PREP score and pulmonary embolism risk score (PERS). The five scales were compared, and their prognostic effects were judged based on the 30-day mortality. Results Among 141 patients, 10(7.09%) died at 30 days. The area under the receiver operating characteristic (ROC) curve (AUC) were 0.687 for PESI, 0.802 for sPESI, 0.786 for Bova, 0.769 for PREP, and 0.668 for PERS, with statistical significance among five scales (P<0.05), the AUC for sPESI being the largest. sPESI had the highest sensitivity of 0.951, PREP had the highest specificity of 0.905, and PESI had the highest Youden index of 1.526. Conclusions sPESI, PREP, and PESI have advantages and disadvantages, but sPESI, the most sensitive with the largest AUC, can be used for the early risk stratification in the population ≥80 years old. However, it is advisable to use it together with other methods because of its low specificity.
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