Table 1.
Baseline characteristics of derivation cohort and validation cohort*.
Table 2.
Predictors of in-hospital death after acute PE (derivation cohort).
Fig 1.
Impact of adding serum sodium and bicarbonate to sPESI for prediction of in-hospital mortality.
The area under the ROC curve (AUC) for sPESI (model 1) (a) for predicting in-hospital death in the derivation cohort was 0.71 (95% CI 0.62–0.80). The AUC for the model sPESI + day-1 Na + day-1 HCO3 (model 2) (b) (Na and HCO3 as continuous variables) for predicting in-hospital death in the derivation cohort was 0.86 (95% CI 0.79–0.93). In the validation cohort the AUC for model 2 (c) was 0.85 (95% CI 0.78–0.92). sPESI, simplified Pulmonary Embolism Severity Index; Na, serum sodium; HCO3, serum bicarbonate; ROC, receiver operating characteristics. The sPESI incorporates age >80 years, history of malignancy, chronic cardiopulmonary disease, heart rate ≥110 beats/minute, systolic blood pressure <100 mmHg and oxyhemoglobin saturation <90%.
Table 3.
Reclassification of patients (derivation cohort).
Fig 2.
Decision curve analysis and predicted impact on admissions resulting from model 2 to guide clinical management.
Net clinical benefit of each of the models across a range of threshold levels of risk of in-hospital death (a). Net reduction in admissions as a result of the use of model 2 to guide clinical management compared to admitting all patients with acute PE (b). Model 1 represents sPESI, model 2 represents sPESI + Na + HCO3. sPESI, simplified Pulmonary Embolism Severity Index; Na, serum sodium; HCO3, serum bicarbonate.