Publication
Derivation and external validation of the SHIeLD score for predicting outcome in normotensive pulmonary embolism
| dc.contributor.author | Freitas, P | |
| dc.contributor.author | Santos, AR | |
| dc.contributor.author | Ferreira, AM | |
| dc.contributor.author | Oliveira, A | |
| dc.contributor.author | Gonçalves, M | |
| dc.contributor.author | Corte-Real, A | |
| dc.contributor.author | Lameiras, C | |
| dc.contributor.author | Maurício, J | |
| dc.contributor.author | Ornelas, E | |
| dc.contributor.author | Matos, C | |
| dc.contributor.author | Faria, D | |
| dc.contributor.author | Augusto, J | |
| dc.contributor.author | Simões, J | |
| dc.contributor.author | Morais, C, et al. | |
| dc.date.accessioned | 2019-03-11T17:29:01Z | |
| dc.date.available | 2019-03-11T17:29:01Z | |
| dc.date.issued | 2019 | |
| dc.description.abstract | Identifying patients with normotensive pulmonary embolism (PE) who may benefit from thrombolysis remains challenging. We sought to develop and validate a score to predict 30-days PE-related mortality and/or rescue thrombolysis. METHODS: We retrospectively assessed 554 patients with normotensive PE. Independent predictors of the studied endpoint were identified from variables available at admission in the emergency department and were used to create a score. The model was validated in 308 patients from a separate hospital. RESULTS: A total of 64 patients died or needed rescue thrombolysis (44 in the derivation cohort). Four independent prognostic factors were identified: Shock index ≥ 1.0 (OR 3.33; 95% CI 1.40-7.93; P = 0.006), HypoxaemIa by the PaO2/FiO2 ratio (OR 0.92 per 10 units; 95% CI 0.88-0.97; P < 0.001), Lactate (OR 1.38 per mmol/L; 95% CI 1.09-1.75; P = 0.008) and cardiovascular Dysfunction (OR 5.67; 95% CI 2.60-12.33; P < 0.001) - SHIeLD score. In the development cohort, event rates for each risk tercile were 0.0%, 2.2%, and 21.6%. In the validation cohort, corresponding rates were 0.0%, 1.9%, and 14.3%. The C-statistic was 0.90 (95% CI 0.86-0.94, P < 0.001) in the derivation cohort and 0.82 (95% CI 0.75-0.89, P < 0.001) in the validation cohort. Decision curve analysis showed that the SHIeLD score is able to accurately identify more true positive cases than the European Society of Cardiology decision criteria. CONCLUSIONS: A risk score to predict 30-days PE-related mortality and/or rescue thrombolysis in patients with normotensive PE was developed and validated. This score may assist physicians in selecting patients for closer monitoring or aggressive treatment strategy. | pt_PT |
| dc.description.version | info:eu-repo/semantics/publishedVersion | pt_PT |
| dc.identifier.citation | Int J Cardiol. 2019 Apr 15;281:119-124. | pt_PT |
| dc.identifier.doi | 10.1016/j.ijcard.2018.12.062 | pt_PT |
| dc.identifier.issn | 1874-1754 | |
| dc.identifier.uri | http://hdl.handle.net/10400.10/2158 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.publisher | Elsevier | pt_PT |
| dc.subject | Pulmonary embolism | pt_PT |
| dc.subject | Biomarkers | pt_PT |
| dc.subject | Biomarkers | pt_PT |
| dc.title | Derivation and external validation of the SHIeLD score for predicting outcome in normotensive pulmonary embolism | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.conferencePlace | Amsterdam | pt_PT |
| oaire.citation.endPage | 124 | pt_PT |
| oaire.citation.startPage | 119 | pt_PT |
| oaire.citation.title | International Journal of Cardiology | pt_PT |
| oaire.citation.volume | 281 | pt_PT |
| rcaap.rights | closedAccess | pt_PT |
| rcaap.type | article | pt_PT |