Classification of high-risk with cardiac troponin and shock index in normotensive patients with pulmonary embolism.
J Thromb Thrombolysis
; 43(2): 179-183, 2017 Feb.
Article
em En
| MEDLINE
| ID: mdl-27800569
ABSTRACT
Accurate risk stratification of normotensive patients with acute pulmonary embolism (PE) require further investigation. We aimed to develop a simple model using clinical (shock index) and laboratory findings (cardiac Troponin, echocardiography) to assess the risk of 30-day mortality in normotensive patients with acute PE. In this retrospective study, 489 normotensive patients with acute PE diagnosed objectively. The primary end-point was defined as a all cause 30-day mortality. Shock index was calculated on admission. The primary end-point occurred in 67 (13.7%, 95% CI 10.7-16.8) patients with acute PE. Predictors of complications included elevated cardiac troponin (OR 1.7, 95% CI 1.3-2.2) and shock index (OR 1.3, 95% CI 1.1-1.5) by multivariable analysis. Risk index point was created based on OR. The model identified stages (stage I 0-1 point, stage II 2 points and stage III 3 point) with 30-day mortality rates of 4.3, 19 and 38.6 %, respectively. The shock index and cardiac troponin can be safely used in combination to determine intermediate risk in patients with PE in emergency departmant. The study provided observations that will require prospective validation before the proposed risk score is adopted in clinical practice.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
6_ODS3_enfermedades_notrasmisibles
Base de dados:
MEDLINE
Assunto principal:
Embolia Pulmonar
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Choque
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Medição de Risco
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Troponina I
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Thromb Thrombolysis
Ano de publicação:
2017
Tipo de documento:
Article