Highlights
- •Pulmonary embolism (PE) is a common and dangerous disease. PESI can accurately stratify the risk of PE patients. However, there are many variables in PESI, and for emergency or respiratory physicians with busy clinical work, it takes more time and effort to evaluate. In addition, previous studies have shown that the prognosis of PE patients varies by race. The aim of this study was to develop a new, simpler multiracial model to assess 30-day survival in PE patients.
- •This study used the MIMIC-III database to construct a new nomogram for predicting 30-day survival in PE patients. The new nomogram contains only 7 variables, which is more convenient to use. Compared with PESI, the new nomogram also had good predictive power. The new nomogram incorporates the race variable and thus can assess the prognosis of PE patients of different races.
- •Our new nomogram makes it easier for clinicians to assess the prognosis of PE patients and saves time and effort in assessment. In addition, our model also has the ability to evaluate the prognosis of PE patients of different races, and also has good predictive power.
Abstract
Background
Pulmonary embolism (PE) is a disease caused by blood clots, tumor embolism, and other
emboli within the pulmonary arteries. Various scoring scales are used for PE. One
such same is the PESI, but it has 12 variables, making it inconvenient for clinical
application.
Objectives
The aim of this study was to develop a new simple nomogram model to assess 30-day
survival in PE patients. The new nomogram makes it easier and faster for clinicians
to assess the prognosis of patients with PE.
Methods
We collected data about the patients with PE from the Medical Information Mart for
Intensive Care-III (MIMIC-III) database and used the receiver operating characteristic
(ROC) curve, area under the ROC curve (AUROC), calibration plot, integrated discrimination
improvement (IDI), and decision curve analysis (DCA) to evaluate the predictive power
of the new model, and compared these with the PESI.
Results
According to the multivariable Cox regression model results, alongside the actual
clinical conditions, we included the following seven variables: race, bicarbonate,
age, tumor, systolic blood pressure (SBP), body temperature, and oxygen saturation
(Spo2). The AUROC of the new model was greater than 0.70. Its IDI exceeded 0, but
with P-value>0.05.
Conclusion
The predictive performance of the new model was not worse than the PESI, but the new
model only has seven variables, and is therefore more convenient for clinicians to
use.
Keywords
Abbreviation:
MIMIC-III (medical information mart for intensive care III), INR (international normalized ratio), PLT (platelets), PT (prothrombin time), SBP (systolic blood pressure), DBP (diastolic blood pressure), Spo2 (blood oxygen saturation), Aids (acquired immune deficiency syndrome)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 03, 2022
Accepted:
September 19,
2022
Received in revised form:
September 16,
2022
Received:
June 2,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
