Background: It is important to identify deterioration in normotensive patients with acute pulmonary embolism (PE). This study aimed to develop a tool for predicting deterioration among normotensive patients with acute PE on admission.
Methods: Clinical, laboratory, and computed tomography parameters were retrospectively collected for normotensive patients with acute PE who were treated at a Chinese center from January 2011 to May 2020 on admission into the hospital. The endpoint of the deterioration was any adverse outcome within 30 days. Eligible patients were randomized 2:1 to derivation and validation cohorts, and a nomogram was developed and validated by the aforementioned cohorts, respectively. The areas under the curves (AUCs) with 95% confidence intervals (CIs) were calculated. A risk-scoring tool for predicting deterioration was applied as a web-based calculator.
Results: The 845 eligible patients (420 men, 425 women) had an average age of 60.05±15.43 years. Adverse outcomes were identified for 81 patients (9.6%). The nomogram for adverse outcomes included heart rate, systolic pressure, N-terminal-pro brain natriuretic peptide, and ventricle/atrial diameter ratios at 4-chamber view, which provided AUC values of 0.925 in the derivation cohort (95% CI: 0.900–0.946, p<0.001) and 0.900 in the validation cohort (95% CI: 0.883–0.948, p<0.001). A risk-scoring tool was published as a web-based calculator (https://gaoyzcmu.shinyapps.io/APE9AD/).
Conclusions: We developed a web-based scoring tool that may help predict deterioration in normotensive patients with acute PE.
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This is a list of supplementary files associated with this preprint. Click to download.
Figure S2. Cardiac measurement diameter a. Short-axis plane; b. Four-chamber view; RV right ventricle; LV left ventricle; RA right atrium; LA left atrium
Figure S1. Thrombus location a. CPA embolism; b. Saddle-CPA embolism; c. non-CPA embolism; CPA, central pulmonary artery
Figure S2. Cardiac measurement diameter a. Short-axis plane; b. Four-chamber view; RV right ventricle; LV left ventricle; RA right atrium; LA left atrium
Figure S1. Thrombus location a. CPA embolism; b. Saddle-CPA embolism; c. non-CPA embolism; CPA, central pulmonary artery
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On 04 Oct, 2020
Invitations sent on 02 Oct, 2020
On 29 Jul, 2020
On 28 Jul, 2020
On 28 Jul, 2020
On 28 Jul, 2020
Posted 17 Dec, 2020
On 13 Dec, 2020
On 12 Dec, 2020
Received 12 Dec, 2020
Received 08 Dec, 2020
Invitations sent on 07 Dec, 2020
On 07 Dec, 2020
On 28 Nov, 2020
On 28 Nov, 2020
On 28 Nov, 2020
On 28 Nov, 2020
Received 27 Nov, 2020
On 23 Nov, 2020
Received 19 Nov, 2020
On 17 Nov, 2020
Invitations sent on 16 Nov, 2020
On 14 Nov, 2020
On 14 Nov, 2020
On 14 Nov, 2020
On 02 Nov, 2020
Received 28 Oct, 2020
On 15 Oct, 2020
Received 14 Oct, 2020
On 04 Oct, 2020
Invitations sent on 02 Oct, 2020
On 29 Jul, 2020
On 28 Jul, 2020
On 28 Jul, 2020
On 28 Jul, 2020
Background: It is important to identify deterioration in normotensive patients with acute pulmonary embolism (PE). This study aimed to develop a tool for predicting deterioration among normotensive patients with acute PE on admission.
Methods: Clinical, laboratory, and computed tomography parameters were retrospectively collected for normotensive patients with acute PE who were treated at a Chinese center from January 2011 to May 2020 on admission into the hospital. The endpoint of the deterioration was any adverse outcome within 30 days. Eligible patients were randomized 2:1 to derivation and validation cohorts, and a nomogram was developed and validated by the aforementioned cohorts, respectively. The areas under the curves (AUCs) with 95% confidence intervals (CIs) were calculated. A risk-scoring tool for predicting deterioration was applied as a web-based calculator.
Results: The 845 eligible patients (420 men, 425 women) had an average age of 60.05±15.43 years. Adverse outcomes were identified for 81 patients (9.6%). The nomogram for adverse outcomes included heart rate, systolic pressure, N-terminal-pro brain natriuretic peptide, and ventricle/atrial diameter ratios at 4-chamber view, which provided AUC values of 0.925 in the derivation cohort (95% CI: 0.900–0.946, p<0.001) and 0.900 in the validation cohort (95% CI: 0.883–0.948, p<0.001). A risk-scoring tool was published as a web-based calculator (https://gaoyzcmu.shinyapps.io/APE9AD/).
Conclusions: We developed a web-based scoring tool that may help predict deterioration in normotensive patients with acute PE.
Figure 1
Figure 1
Figure 1
Figure 1
Figure 1
Figure 1
Figure 1
Figure 1
Figure 1
Figure 1
Figure 1
Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
Figure S2. Cardiac measurement diameter a. Short-axis plane; b. Four-chamber view; RV right ventricle; LV left ventricle; RA right atrium; LA left atrium
Figure S1. Thrombus location a. CPA embolism; b. Saddle-CPA embolism; c. non-CPA embolism; CPA, central pulmonary artery
Figure S2. Cardiac measurement diameter a. Short-axis plane; b. Four-chamber view; RV right ventricle; LV left ventricle; RA right atrium; LA left atrium
Figure S1. Thrombus location a. CPA embolism; b. Saddle-CPA embolism; c. non-CPA embolism; CPA, central pulmonary artery
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