A new index for the prediction of in-hospital mortality in patients with acute pulmonary embolism: The modified shock index

dc.authorid0000-0001-6560-6503
dc.contributor.authorTürkday Derebey, Sevim
dc.contributor.authorTokgöz, Hacer Ceren
dc.contributor.authorKeskin, Berhan
dc.contributor.authorTosun, Ayhan
dc.contributor.authorHakgör, Aykun
dc.contributor.authorKaragöz, Ali
dc.contributor.authorAkbal, Özgür Yaşar
dc.contributor.authorBayram, Zübeyde
dc.contributor.authorEfe, Süleyman
dc.contributor.authorDoğan, Cem
dc.contributor.authorTanboğa, İbrahim Halil
dc.contributor.authorÖzdemir, Nihal
dc.contributor.authorKaymaz, Cihangir
dc.date.accessioned2023-05-23T10:32:56Z
dc.date.available2023-05-23T10:32:56Z
dc.date.issued2023
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Kardiyoloji Ana Bilim Dalı
dc.description.abstractBACKGROUND: Pulmonary embolism severity index, its simplified version, and shock index have been used for risk stratification in acute pulmonary embolism. In this study, we proposed a modification in severity index and evaluated the correlates and prognostic value of modification in severity index in this setting. METHODS: The study group comprised retrospectively evaluated 181 patients with acute pulmonary embolism. Systematic workup including pulmonary embolism severity index, its simplified version, shock index, biomarkers, and echocardiographic and multidetector computed tomography assessments was performed in all patients. Moreover, we calculated modification in severity index by multiplying original shock index (heart rate/systolic blood pressure ratio) and a third component, 1/pulse oxymetric saturation (pSat O2%) ratio. The primary endpoint was defined as all-cause mortality and hemodynamic collapse during the hospital stay. RESULTS: On the basis of initial risk stratification, ultrasound-assisted thrombolysis, systemic tissue-type plasminogen activator, and unfractionated heparin therapies were utilized in 83 (45.9%), 37 (20.4%), and 61 (33.7%) patients, respectively. The primary end-point occurred in 13 (7.2%) patients. Receiver-operating curve analysis revealed that modification in severity index had the highest area under the curve of 0.739 (0.588-0.890, P =.002) compared with shock index, pulmonary embolism severity index, or its simplified version. The modification in severity index > 0.989 predicted primary endpoint with 73% sensitivity and 54% specificity. CONCLUSIONS: The modification in severity index seems to be a simple, quick, and compre-hensive risk assessment tool for bedside evaluation at initial stratification, in monitoring the clinical benefit from therapies, and decision-making for escalation to other reperfusion strategies in patients with acute pulmonary embolism. However, the prognostic value of modification in severity index needs to be validated with further studies.
dc.identifier.citationTürkday Derebey, S., Tokgöz, H. C., Keskin, B., Tosun, A., Hakgör, A., Karagöz, A. ... Kaymaz, C. (2023). A new index for the prediction of in-hospital mortality in patients with acute pulmonary embolism: The modified shock index. Anatolian Journal of Cardiology, 27(5), 282-289. https://doi.org/10.14744/AnatolJCardiol.2023.2530
dc.identifier.doi10.14744/AnatolJCardiol.2023.2530
dc.identifier.endpage289
dc.identifier.issn2149-2263
dc.identifier.issn2149-2271
dc.identifier.issue5
dc.identifier.pmid37119189
dc.identifier.scopus2-s2.0-85156179362
dc.identifier.scopusqualityQ3
dc.identifier.startpage282
dc.identifier.trdizinid1178589
dc.identifier.urihttps://doi.org/10.14744/AnatolJCardiol.2023.2530
dc.identifier.urihttps://hdl.handle.net/20.500.12511/10955
dc.identifier.volume27
dc.identifier.wos001077061500010en_US
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakTR-Dizin
dc.indekslendigikaynakPubMed
dc.institutionauthorHakgör, Aykun
dc.language.isoen
dc.publisherNLM (Medline)
dc.relation.ispartofAnatolian Journal of Cardiologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsAttribution-NonCommercial 4.0 International*
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/*
dc.subjectPulmonary Embolism
dc.subjectRisk Stratification
dc.subjectThrombolytic Therapy
dc.titleA new index for the prediction of in-hospital mortality in patients with acute pulmonary embolism: The modified shock index
dc.typeArticle

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