Risk Assessment Strategies in Pulmonary Embolism

Risk Stratification in Pulmonary Embolism

The aim of this study is to evaluate different scores of risk assessment in patients with pulmonary embolism. This study aim to compare the accuracy of these scores in predicting mortality during hospital admission.

Pulmonary embolism (PE) is a potentially life-threatening cardiovascular emergency with a high mortality rate.Approximately 1% of all hospitalized patients and 10% of all in-hospital mortalities are PE related. Adding to this, acute PE is linked to comparatively high (≥13%) short-term mortalities that occur either in hospital or within 30 days.

Some studies have demonstrated that PE may indicate increased 1-year mortality rates up to 25%,,. Therefore, PE is considered a potentially fatal disease, although patients who escape a PE-related death are still endangered by hematologic mishaps, especially recurrence of VTE and/or PE, or on the contrary, serious hemorrhage5.

Risk stratification of patients with acute PE is mandatory for determining the appropriate therapeutic management approach. Risk classification of PE can discriminate low-risk patients, who can be medicated as outpatients, from others at high risk, in whom a profit from intensive care unit admission or even in-hospital thrombolytic therapy is expected.

Inclusion Criteria:

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All patients will be subjected to the following:

1. Complete history taking and clinical examination.
2. Chest x-ray
3. ECG and echocardiography.
4. Arterial blood gases.
5. Multislice CT angiography of the chest.
6. Laboratory tests and biomarkers.

Exclusion Criteria:

• 1- Patients with unexpected or accidental diagnosis of PE (patients undergoing diagnostic tests for another suspected disease.

  2- Patients with acute left heart failure or acute respiratory failure responsible for symptoms.

  3- Patient with recurrent PE (only the first event was included in the analysis).