The Value of Using sPESI Score Combined with hs-TnT in the Evaluation of Short-term Prognosis in Hemodynamically Stable Pulmonary Embolism

Lei Wen; Zhang Tao; Zheng Cao; Wang Ying; Wu Wen Juan; Yang Mei Juan; Dong Zhao Xing

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Lei Wen , Zhang Tao , Zheng Cao , Wang Ying , Wu Wen Juan , Yang Mei Juan , Dong Zhao Xing . The Value of Using sPESI Score Combined with hs-TnT in the Evaluation of Short-term Prognosis in Hemodynamically Stable Pulmonary Embolism[J]. Journal of Kunming Medical University, 2018, 39(02): 65-70.

Citation:

Lei Wen , Zhang Tao , Zheng Cao , Wang Ying , Wu Wen Juan , Yang Mei Juan , Dong Zhao Xing . The Value of Using sPESI Score Combined with hs-TnT in the Evaluation of Short-term Prognosis in Hemodynamically Stable Pulmonary Embolism[J]. Journal of Kunming Medical University, 2018, 39(02): 65-70.

Citation:

Lei Wen , Zhang Tao , Zheng Cao , Wang Ying , Wu Wen Juan , Yang Mei Juan , Dong Zhao Xing . The Value of Using sPESI Score Combined with hs-TnT in the Evaluation of Short-term Prognosis in Hemodynamically Stable Pulmonary Embolism[J]. Journal of Kunming Medical University, 2018, 39(02): 65-70.

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The Value of Using sPESI Score Combined with hs-TnT in the Evaluation of Short-term Prognosis in Hemodynamically Stable Pulmonary Embolism

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基金：国家自然科学基金资助项目 (81360015, 81560015); 云南省科技厅-昆明医科大学应用基础研究昆医联合专项基金资助项目[2017FE468 (-210) ]; 云南省教育厅科学研究基金重点资助项目 (2015Z084);

Received Date: 2017-09-22

Abstract

Abstract

Objective To explore the value of using sPESI score and hs-TnT in the evaluation of short-term prognosis in hemodynamically stable pulmonary embolism. Methods We collected 99 patients with hemodynamically stable PE from our department. According to the sPESI score and hs-TnT, patients were divided into high risk group (sPESI score ≥1) and low risk group ( sPESI score=0) , positive group (hs-TnT ≥0.014 ng/m L) and negative group (hs-TnT<0.014 ng/m L) . Then all patients were treated and followed up for 30 days. The sensitivity, specificity, positive predictive value and negative predictive value of adverse events of prognosis were calculated, and ROC curve was drawn to analyze the values in different grouping methods for the prognostic evaluation.Results Thirteen adverse events occurred in all patients. The single test showed that sensitivity, specificity, positive predictive value, and negative predictive value of hs-TnT for predicting adverse events were respectively 84.6%, 55.2%, 22%, and 96%. When sPESI was used alone, sensitivity, specificity, positive predictive value and negative predictive value were 92.3%, 48.8%, 21.1%, and 97.7%. Results of combined testing showed 100% sensitivity, 29% specificity, 17.6% positive predictive value, and 100% negative predictive value. The ROC curve area of the sPESI, hs-TnT, sPESI and hs-TnT are 0.832 ( 95% CI, 0.705-0.958) , 0.825 ( 95% CI, 0.694-0.957) , 0.872 ( 95% CI, 0.773-0.971) . ConclusionsPESI and hs-TnT have clinical value in evaluating the short-term prognosis of hemodynamically stable pulmonary embolism. sPESI combined with hs-TnT has higher significance, especially in patients with low-risk PE.
- Hemodynamically stable,
- Pulmonary embolism,
- sPESI,
- hs-TnT

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References(22)

References

[1]	[1]SILVERSTEINMD, HEITJA, MOHRDN, etal.Trendsinthe incidenceofdeepveinthrombosisandpulmonaryembolism:a25-year population-based study[J].Archives of Internal Medicine, 1998, 158 (6) :585-593.
[2]	[2]OGERE.Incidenceofvenousthromboembolism:acommunity-based study in Western France.EPI-GETBP Study Group.Grouped’Etudedela thrombosede Bretagne Occidentale[J].Thromb Haemost, 2000, 83 (5) :657-660.
[3]	[3] KEARONC, AKLEA, COMEROTAAJ, etal.Antithrombotic therapyfor VTE disease:antithrombotic therapy and preventionofthrombosis, 9thed:americancollegeofchestphysicians evidence-basedclinicalpracticeguidelines[J].Chest, 2012, 141 (2) :419-497.
[4]	[4]DOUKETISJD, KEARONC, BATESS, etal.Riskoffatalpulmonaryembolisminpatientswithtreatedvenousthromboembolism[J].Jamathe Journalofthe American Medical Association, 1998, 279 (6) :458-462.
[5]	[5]KONSTANTINIDES S V, TORBICKI A, AGNELLI G, et al.2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism the task force for the diagnosis and management of acute pulmonary embolism of the european societyofcardiology (ESC) endorsedbytheeuropean respiratory society (ERS) [J].European Heart Journal, 2014, 35 (43) :3033-3073.
[6]	[6]ATASOYMM, SARIMANN, LEVENTE, etal.Nonsevereacutepulmonaryembolism:prognostic CTpulmonaryangiography findings[J].Journal of Computer Assisted Tomography, 2015, 39 (2) :166-170.
[7]	[7]LANKEITM, FRIESEND, ASCHOFFJ, etal.Highlysensitive troponin T assay in normotensive patients with acute pulmonaryembolism[J].European Heart Journal, 2010, 31 (15) :1836-1844.
[8]	[8]JIMENEZD, AUJESKYD, MOORESL, etal.Simplicationof thepulmonaryembolismseverityindexforprognosticationin patients with acute symptomatic pulmonary embolism[J].Arch Intern Med, 2010, 170 (15) :1383-1389.
[9]	[9]ADAM T, ARNAUD P, KONSTANTINIDES S, et al.Guidelines on the diagnosis and management of acute pulmonary embolism[J].Giornale Italiano Di Cardiologia, 2009, 10 (5) :1301-1336.
[10]	[10]MAREIKEL, DAVIDJ, MACIEJK, etal.Predictivevalueofthe high-sensitivity troponin T assay and the simplified pulmonary embolism severity index in hemodynamically stable patients with acute pulmonary embolism:a prospective validationstudy[J].Circulation, 2011, 124 (24) :2716-2724.
[11]	[11]AUJESKYD, ROYPM, LEMANACHCP, etal.Valida-tionof a model to predict adverse outcomes in patients with pulmonaryembolism[J].Eur Heart J, 2006, 27 (4) :476-481.
[12]	[12]WICKIJ, PERRIERA, PERNEGERTV, etal.Predictingadverse out-come in patients with acute pulmonary embolism:a riskscore[J].Thromb Haemost, 2000, 84 (4) :548-552.
[13]秦志强.预测肺栓塞患者临床结果的因素[J].国际内科学杂志, 2009, 36 (2) :116-119.
[14]	[14]BECATTINI C, VEDOVATI M C, AGNELLI G.Prognostic valueoftroponinsinacutepulmonaryembolism:ameta-analysis[J].Circulation, 2007, 116 (4) :427-433.
[15]中华医学会心血管病学分会肺血管病学组, 中国医师协会心血管内科医师分会.急性肺血栓栓塞症诊断治疗中国专家共识[J].中华内科杂志, 2010, 49 (1) :74-81.
[16]	[16]EARONC, AKLEA, COMEROTAA J, et al.Antithrombotic therapyfor VTEDisease:antithrombotictherapyandpreventionofthrombosis, 9th ed:american cllege ofchest physicians evidence-basedclinicalpracticeguidelines[J].Chest, 2012, 141 (2Suppl) :1513-1514.
[17]	[17]DINISIOM, VANESN, BLLERHR, etal.Deepveinthrombosis and pulmonary embolism[J].Lancet, 2016, 388 (10063) :3060-3073.
[18]	[18]ACDAAKGLLU, MRANKURTOMRLU, ERYILMAZU, etal.Predictorsofearlydeathinpatientswith acute pulmonary embolism.[J].American Journal of Emergency Medicine, 2015, 33 (2) :214-221.
[19]	[19] MAREIKEL, DAVIDJ, MACIEJK, etal.Predictivevalueof the high-sensitivity troponin T assay and the simplified Pulmonary Embolism Severity Index in hemodynamicallystable patients with acute pulmonary embolism:a prospective validationstudy.[J].Circulation, 2011, 124 (24) :2716-2724.
[20]	[20]DRAHOMIRA, PIERRE-MARIER, FRANCKV, etal.Outpatient versus inpatient treatment for patients with acute pulmonaryembolism:aninternational, open-label, randomised, non-inferioritytrial[J].Lancet, 2011, 378 (9785) :41-48.
[21]	[21]ZONDAGW, KOOIMANJ, KLOKFA, etal.Outpatientversusinpatienttreatmentinpatientswithpulmonaryembolism:a meta-analysis[J].Eur Respir, 2013, 42 (1) :134-144.
[22]	[22]LONGB, KOYFMANA.Bestclinicalpractice:Controversies in outpatient management of acute pulmonary embolism[J].Emerg Med J, 2017, 52 (5) :668-679.

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