Validation of a model to predict adverse outcomes in patients with pulmonary embolism
Validation of a model to predict adverse outcomes in patients with pulmonary embolism
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DOI：
10.1093/eurheartj/ehi588
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发表时间：
2006-02-01
影响因子：
39.3
通讯作者：
Fine, MJ
中科院分区：
文献类型：
--
作者：
Aujesky, D;Roy, PM;Fine, MJ
目的验证肺栓塞（PE）患者预后的量化模型。该模型以前来自10 534 US patients.Methods和结果我们验证了该模型在367例前瞻性诊断PE在117欧洲急诊科。我们使用模型的11个预后变量的基线数据将患者分为五个风险类别（I-V）。我们比较了每个风险类别内的90天死亡率以及验证样本和原始衍生样本之间的受试者工作特征曲线下面积。我们还评估了每个风险类别中静脉血栓栓塞复发率和大出血率。I类风险的死亡率为0%，II类为1.0%，III类为3.1%，IV类为10.4%，V类为24.4%，验证样本和原始衍生样本之间无差异。验证样品的曲线下面积较大（0.87 vs. 0.78，P=0.01）。I类和II类中没有患者复发血栓栓塞或大出血。结论该模型准确地将PE患者分为死亡率和其他相关并发症风险增加的类别。I类和II类风险患者的不良结局风险较低，是门诊治疗的潜在候选人。
Aims To validate a model for quantifying the prognosis of patients with pulmonary embolism (PE). The model was previously derived from 10 534 US patients.Methods and results We validated the model in 367 patients prospectively diagnosed with PE at 117 European emergency departments. We used baseline data for the model's 11 prognostic variables to stratify patients into five risk classes (I-V). We compared 90-day mortality within each risk class and the area under the receiver operating characteristic curve between the validation and the original derivation samples. We also assessed the rate of recurrent venous thrombo-embolism and major bleeding within each risk class. Mortality was 0% in Risk Class I, 1.0% in Class II, 3.1% in Class III, 10.4% in Class IV, and 24.4% in Class V and did not differ between the validation and the original derivation samples. The area under the curve was larger in the validation sample (0.87 vs. 0.78, P=0.01). No patients in Classes I and II developed recurrent thrombo-embolism or major bleeding.Conclusion The model accurately stratifies patients with PE into categories of increasing risk of mortality and other relevant complications. Patients in Risk Classes I and II are at low risk of adverse outcomes and are potential candidates for outpatient treatment.