Document Type
Article
Publication Date
8-25-2024
Abstract
OBJECTIVES: To construct a new scoring system utilizing biomarkers, vitals, and imaging data to predict 30-day mortality in acute pulmonary embolism (PE).
BACKGROUND: Acute PE, a well-known manifestation of venous thromboembolic disease, is responsible for over 100,000 deaths worldwide yearly. Contemporary management algorithms rely on a multidisciplinary approach to care via PE response teams (PERT) in the identification of low, intermediate, and high-risk patients. The PESI and sPESI scores have been used as cornerstones of the triage process in assigning risk of 30-day mortality for patients presenting with acute PE; however, the specificity of these scoring systems has often come into question.
METHODS: This study retrospectively analyzed 488 patients with acute PE who were managed at a tertiary care institution with either conservative therapy consisting of low molecular weight or unfractionated heparin, advanced therapies consisting of catheter directed therapies, aspiration thrombectomy, or a combination of these therapies, or surgical embolectomy. The CLOT-5 score was designed to include vital signs, biomarkers, and imaging data to predict 30-day mortality in patients presenting with acute PE.
RESULTS: The CLOT-5 score had an area under the curve (AUC) of 0.901 with a standard error of 0.29, while the PESI and sPESI scores had an AUC and standard errors of 0.793 ±- 0.43 and 0.728 ± 0.55, respectively.
CONCLUSIONS: When incorporated into the management algorithms of national PERT programs, the CLOT-5 score may allow for rapid and comprehensive assessment of patients with acute PE at high risk for clinical decompensation, leading to early escalation of care where appropriate.
Recommended Citation
Marginean, Alexandru; Arora, Punit; Walsh, Kevin; Bruno, Elizabeth; Sawalski, Cathryn; Gupta, Riya; Greathouse, Frances; Clarke, Jacob; Mallery, Quinn; Choi, Myoung Hyun; Malas, Waddah; Shah, Parth; Sutherland, David; Kumar, Amudha; Wroblewski, Igor; Elkaryoni, Ahmed; Desai, Parth; Brailovsky, Yevgeniy; and Darki, Amir, "Utilization of a Novel Scoring System in Predicting 30-day Mortality in Acute Pulmonary Embolism, the CLOT-5 Pilot Study" (2024). Division of Cardiology Faculty Papers. Paper 153.
https://jdc.jefferson.edu/cardiologyfp/153
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
Language
English
PubMed ID
39183532
Comments
This article is the author's final published version in Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, Volume 30, August 2024.
The published version is available at https://doi.org/10.1177/10760296241278353.
Copyright © The Author(s) 2024