Advertisement
Advertisement
Advertisement

Validation of a risk score identifying patients with acute pulmonary embolism, who are at low risk of clinical adverse outcome

Journal: Thrombosis and Haemostasis
ISSN: 0340-6245
DOI: http://dx.doi.org/10.1160/TH04-01-0034
Issue: 2004: 91/6 (June) pp. 1056-1259
Pages: 1232-1236

Validation of a risk score identifying patients with acute pulmonary embolism, who are at low risk of clinical adverse outcome

Mathieu R. Nendaz (1), Patrick Bandelier (2), Drahomir Aujesky (3), Jacques Cornuz (3), Pierre-Marie Roy (4), Henri Bounameaux (2), Arnaud Perrier (1)
(1) Medical Clinic 1, Department of Internal Medicine, Geneva University Hospitals, Geneva, Switzerland (2) Division of Angiology and Haemostasis, Department of Internal Medicine, Geneva University Hospitals, Geneva, Switzerland (3) Department of Medici

Summary

A clinical predictive model that accurately identifies patients with pulmonary embolism who are at low risk of adverse medical outcomes may be useful for management decisions, such as outpatient treatment. We aimed to externally validate a previously derived prognostic score identifying emergency ward patients with acute pulmonary embolism at low risk of 3- month complications. One hundred and ninety-nine consecutive patients with proven pulmonary embolism were included from the emergency centres of three teaching and general hospitals. Adverse outcomes, such as death, major bleed, or recurrent venous thromboembolism, were recorded during a 3- month follow-up. We retrospectively computed the prognostic score for each patient and determined its predictive accuracy at different threshold values. The overall 3-month risk of adverse event after the diagnosis of pulmonary embolism was 9.5%. At a threshold of 2 points, eight patients with scores at or below the cut-off (5%; 95% CI 2.6-9.6) and 11 patients with scores above this cut-off (27.5%; 95% CI 16.1-42.8) presented a complication.The negative predictive value for an adverse outcome was 95.0% (95% CI 90.4-97.4). The receiver operating characteristic curve derived from the score distribution had an area of 0.77 (95% CI 0.65-0.89).This compared favourably with the characteristics of the derivation study. We conclude that the Geneva risk score has an acceptable predictive accuracy to identify patients with pulmonary embolism at low risk for 3- month adverse outcomes.Whether this score remains accurate and useful in clinical practice should be determined in a prospective multicentre validation study.

DOI

http://dx.doi.org/10.1160/TH04-01-0034

Thrombosis News

Mobile technology identifies people with unknown atrial fibrillation at high risk of stroke – article published in Thrombosis and Haemostasis

The article “Feasibility and cost effectiveness of stroke prevention through community screening...

TH 111.4

The April 2014 TH 111.4 issue of Thrombosis and Haemostasis is a Theme Issue by Guest Editor B....

TH 111.3

Women with atrial fibrillation have a much higher risk for thromboembolic stroke than men suffering...