SIRENA score for in-hospital mortality risk assessment in patients with acute pulmonary embolism
Aim. To create a new prognostic scale for in-hospital mortality risk assessment in patients with pulmonary embolism (PE).Material and methods. The study was carried out on the basis of Russian register of acute pulmonary embolism SIRENA.Results. Based on the Russian register of acute pulmonary embol...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | Russian |
| Published: |
«FIRMA «SILICEA» LLC
2021-01-01
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| Series: | Российский кардиологический журнал |
| Subjects: | |
| Online Access: | https://russjcardiol.elpub.ru/jour/article/view/4231 |
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| Summary: | Aim. To create a new prognostic scale for in-hospital mortality risk assessment in patients with pulmonary embolism (PE).Material and methods. The study was carried out on the basis of Russian register of acute pulmonary embolism SIRENA.Results. Based on the Russian register of acute pulmonary embolism SIRENA (n=609; women — 50,7%; mean age — 63,0±1,5 years), independent predictors of in-hospital death were determined: left ventricular ejection fraction <40%, immobilization in the last 12 months, creatinine clearance <50 ml/min, syncope as a PE symptom, cyanosis at admission. Each of these factors with a value of 1 became a component of the novel SIRENA score. At the score of 0, 1, 2, 3 and more, in-hospital mortality was 3,1%, 7,0%, 16,7% and 40,0%, respectively. Mortality with a SIRENA score <2 (low risk) was 5,0%, and with a score ≥2 (high risk) — 24,3% (relative risk (RR), 4,87; 95% confidence interval (CI), 2,97-7,98; p<0,001). Predictive sensitivity and specificity for in-hospital mortality were 62,7% and 78,5%, respectively. The area under the ROC curve was 0,76 (95% CI, 0,690,83), which did not differ significantly from sPESI score — 0,73 (95% CI, 0,66-0,80). With a high risk for sPESI and SIRENA, the mortality was 27,1%, which was significantly higher compared to patients with a high risk only for sPESI — 13,9% (RR, 1,94; 95% CI, 1,36-2,82; p<0,001), but did not differ significantly compared with patients at high risk according to SIRENA score — 24,3% (RR, 1,11; 95% CI, 0,75-1,65; p=0,78).Conclusion. Based on the Russian register of acute pulmonary embolism, the SIRENA score was developed, which has a high accuracy (sensitivity, 62,7%; specificity, 78,5%) in predicting in-hospital mortality. |
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| ISSN: | 1560-4071 2618-7620 |