Echocardiography and pulmonary embolism severity index have independent prognostic roles in pulmonary embolism

Sanchez, Olivier; Trinquart, Ludovic; Planquette, Benjamin; Couturaud, Francis; Verschuren, Franck; Caille, Vincent; Meneveau, Nicolas; Pacouret, Gérard; Roy, Pierre-Marie; Righini, Marc Philip; Perrier, Arnaud; Bertoletti, Laurent; Parent, Florence; Lorut, Christine; Meyer, Guy

doi:10.1183/09031936.00097512

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Title		Echocardiography and pulmonary embolism severity index have independent prognostic roles in pulmonary embolism
Authors		Sanchez, Olivier Trinquart, Ludovic Planquette, Benjamin Couturaud, Francis Verschuren, Franck Caille, Vincent Meneveau, Nicolas Pacouret, Gérard Roy, Pierre-Marie Righini, Marc Philip Perrier, Arnaud Bertoletti, Laurent Parent, Florence Lorut, Christine Meyer, Guy show all authors [1 - 15]
Published in		European respiratory journal. 2013, vol. 42, no. 3, p. 681-8
Abstract		We analysed a cohort of patients with normotensive pulmonary embolism (PE) in order to assess whether combining echocardiography and biomarkers with the pulmonary embolism severity index (PESI) improves the risk stratification in comparison to the PESI alone. The PESI was calculated in normotensive patients with PE who also underwent echocardiography and assays of cardiac troponin I and brain natriuretic peptide. 30-day adverse outcome was defined as death, recurrent PE or shock. 529 patients were included, 25 (4.7%, 95% CI 3.2-6.9%) had at least one outcome event. The proportion of patients with adverse events increased from 2.1% in PESI class I-II to 8.4% in PESI class III-IV, and to 14.3% in PESI class V (p<0.001). In PESI class I-II, the rate of outcome events was significantly higher in patients with abnormal values of biomarkers or right ventricular dilatation. In multivariate analysis, the PESI (class III-IV versus I-II, OR 3.1, 95% CI 1.2-8.3; class V versus I-II, OR 5.5, 95% CI 1.5-25.5 and echocardiography (right ventricular/left ventricular ratio, OR (for an increase of 0.1) 1.3, 95% CI 1.1-1.5) were independent predictors of an adverse outcome. In patients with normotensive PE, biomarkers and echocardiography provided additional prognostic information to the PESI.
Identifiers		DOI: 10.1183/09031936.00097512 PMID: 23258789
Full text		Article (Published version) (348 Kb) - Free access
Structures		Faculté de médecine / Section de médecine clinique / Département de médecine Faculté de médecine / Section de médecine clinique / Département de réadaptation et gériatrie
Research group		La maladie thromboembolique veineuse (808)
Citation (ISO format)		SANCHEZ, Olivier et al. Echocardiography and pulmonary embolism severity index have independent prognostic roles in pulmonary embolism. In: The European respiratory journal, 2013, vol. 42, n° 3, p. 681-8. doi: 10.1183/09031936.00097512 https://archive-ouverte.unige.ch/unige:32985