Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/20342
Title: Assessment of Renal Dysfunction Improves the Simplified Pulmonary Embolism Severity Index (sPESI) for Risk Stratification in Patients with Acute Pulmonary Embolism.
Austin Authors: Trimaille, Antonin;Marchandot, Benjamin;Girardey, Mélanie;Muller, Clotilde;Lim, Han S ;Trinh, Annie;Ohlmann, Patrick;Moulin, Bruno;Jesel, Laurence;Morel, Olivier
Affiliation: Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, 67091 Strasbourg, France
Department of Cardiology, Northern Health, Melbourne 3084, Australia
Department of Cardiology, Austin Health, Heidelberg, Victoria, Australia
Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, 67091 Strasbourg, France
Laboratory of Regenerative Nanomedicine, UMR 1260, INSERM (French National Institute of Health and Medical Research), FMTS (Fédération de Médecine Translationnelle de l'Université de Strasbourg), Faculté de Médecine, Université de Strasbourg, 11 rue Humann, 67085 Strasbourg, France
Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, 67091 Strasbourg, France
Laboratory of Regenerative Nanomedicine, UMR 1260, INSERM (French National Institute of Health and Medical Research), FMTS (Fédération de Médecine Translationnelle de l'Université de Strasbourg), Faculté de Médecine, Université de Strasbourg, 11 rue Humann, 67085 Strasbourg, France
Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, 67091 Strasbourg, France
Pôle NUDE, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, 67091 Strasbourg, France
Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, 67091 Strasbourg, France
Pôle NUDE, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, 67091 Strasbourg, France
Issue Date: 1-Feb-2019
metadata.dc.date: 2019-02-01
Publication information: Journal of clinical medicine 2019; 8(2): E160
Abstract: Whereas the major strength of the simplified pulmonary embolism severity index (sPESI) lies in ruling out an adverse outcome in patients with sPESI of 0, the accuracy of sPESI ≥ 1 in risk assessment remains questionable. In acute pulmonary embolism (APE), the estimated glomerular filtration rate (eGFR) can be viewed as an integrate marker reflecting not only previous chronic kidney disease (CKD) damage but also comorbid conditions and hemodynamic disturbances associated with APE. We sought to determine whether renal dysfunction assessment by eGFR improves the sPESI score risk stratification in patients with APE. 678 consecutive patients with APE were prospectively enrolled. Renal dysfunction (RD) at diagnosis of APE was defined by eGFR < 60 mL/min/1.73 m² and acute kidney injury (AKI) by elevation of creatinine level >25% during in-hospital stay. RD was observed in 26.9% of the cohort. AKI occurred in 18.8%. A stepwise increase in 30-day mortality, cardiovascular mortality and overall mortality was evident with declining renal function. Multivariate analysis identified RD and CRP (C-reactive protein) level but not sPESI score as independent predictors of 30-day mortality. AKI, 30-day mortality, overall mortality, and cardiovascular mortality were at their highest level in patients with eGFR < 60 mL/min/1.73 m² and sPESI ≥1. in patients with APE, the addition of RD to the sPESI score identifies a specific subset of patients at very high mortality.
URI: http://ahro.austin.org.au/austinjspui/handle/1/20342
DOI: 10.3390/jcm8020160
PubMed URL: 30717116
ISSN: 2077-0383
Type: Journal Article
Subjects: cardio-renal syndrome
chronic kidney disease
contrast-induced nephropathy
venous thromboembolism
Appears in Collections:Journal articles

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