Derivation and validation of a prognostic model for pulmonary embolism.

Abstract:

RATIONALE:An objective and simple prognostic model for patients with pulmonary embolism could be helpful in guiding initial intensity of treatment. OBJECTIVES:To develop a clinical prediction rule that accurately classifies patients with pulmonary embolism into categories of increasing risk of mortality and other adverse medical outcomes. METHODS:We randomly allocated 15,531 inpatient discharges with pulmonary embolism from 186 Pennsylvania hospitals to derivation (67%) and internal validation (33%) samples. We derived our prediction rule using logistic regression with 30-day mortality as the primary outcome, and patient demographic and clinical data routinely available at presentation as potential predictor variables. We externally validated the rule in 221 inpatients with pulmonary embolism from Switzerland and France. MEASUREMENTS:We compared mortality and nonfatal adverse medical outcomes across the derivation and two validation samples. MAIN RESULTS:The prediction rule is based on 11 simple patient characteristics that were independently associated with mortality and stratifies patients with pulmonary embolism into five severity classes, with 30-day mortality rates of 0-1.6% in class I, 1.7-3.5% in class II, 3.2-7.1% in class III, 4.0-11.4% in class IV, and 10.0-24.5% in class V across the derivation and validation samples. Inpatient death and nonfatal complications were

authors

Aujesky D,Obrosky DS,Stone RA,Auble TE,Perrier A,Cornuz J,Roy PM,Fine MJ

doi

10.1164/rccm.200506-862OC

keywords:

subject

Has Abstract

pub_date

2005-10-15 00:00:00

pages

1041-6

issue

8

eissn

1073-449X

issn

1535-4970

pii

200506-862OC

journal_volume

172

pub_type

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