背景:肺栓塞(PE)是老年人群死亡率和发病率的重要原因。我们的目的是比较肺栓塞严重程度指数(PESI)的能力,快速急诊医学评分(REMS),低血压,氧饱和度,低温,心电图改变,和独立性丧失(HOTEL)来预测老年PE患者的预后和重症监护需求。
结果:132名患者的中位年龄为77(71-82)岁。非幸存者组的PESI较高[132(113-172)](P=0.001)。REMS中位数为8(7-10),在非幸存者组[10(7.5-12.0)](p=0.005)。整个队列中的HOTEL评分中位数为1(0-2),非幸存者组为2(1-3),表明与幸存者组相比存在显着差异(P=0.001)。HOTEL曲线下面积(AUC)值,REMS,和PESI分别测定为0.72、0.65和0.71。对于重症监护需求的预测,酒店的AUC值,REMS,和PESI分别为0.76、0.75和0.76,在成对比较中没有显着差异(PESI与REMS:p=0.520,酒店与PESI:P=0.526,REMS与酒店:P=0.669,总体测试:P=0.96,DeLong\s测试)。HOTEL和PESI的风险比相互平行[5.31(95%置信区间(CI):2.53-11.13)和5.34(95%CI:2.36-12.08),分别]。
结论:HOTEL和REMS在预测老年PE患者的短期死亡率和重症监护需求方面与PESI一样成功。这些分数也更实用,因为它们具有比PESI更少的参数。
BACKGROUND: Pulmonary embolism (PE) is an important cause of mortality and morbidity in the geriatric population. We aimed to compare the ability of the pulmonary embolism severity index (PESI), rapid emergency medicine score (REMS), and hypotension, oxygen saturation, low temperature, electrocardiogram change, and loss of independence (
HOTEL) to predict prognosis and intensive care requirement in geriatric patient with PE.
RESULTS: The median age of 132 patients was 77 (71-82) years. PESI was higher in the non-survivor group [132 (113-172)] (P =0.001). The median REMS was 8 (7-10), and it was higher in the non-survivor group [10 (7.5-12.0)] (p = 0.005). The median HOTEL score was 1 (0-2) in the whole cohort and 2 (1-3) in the non-survivor group, indicating significant difference compared to the survivor group (P = 0.001). The area under the curve (AUC) values of
HOTEL, REMS, and PESI were determined as 0.72, 0.65, and 0.71, respectively. For the prediction of intensive care requirement, the AUC values of
HOTEL, REMS, and PESI were 0.76, 0.75, and 0.76, respectively, with no significant difference in pairwise comparisons (PESI vs. REMS: p = 0.520,
HOTEL vs. PESI: P = 0.526, REMS vs.
HOTEL: P = 0.669, overall test: P = 0.96, DeLong\'s test). The risk ratios of HOTEL and PESI were parallel to each other [5.31 (95% confidence interval (CI): 2.53-11.13) and 5.34 (95% CI: 2.36-12.08), respectively].
CONCLUSIONS: HOTEL and REMS were as successful as PESI in predicting short-term mortality and intensive care requirement in geriatric patients with PE. These scores are also more practical since they have fewer parameters than PESI.