Comparing the "simplified revised Geneva score", the "original PESI", and the "simplified PESI" for mortality prediction for pulmonary embolism. A 10 years follow-up study.

Abstract

Background: The purpose of this research was to investigate and compare the utilization of the revised Geneva score, original PESI, and simplified PESI in predicting the long-term mortality rate of patients with pulmonary embolism (PE).

Methods: This retrospective investigation was conducted in Isfahan between June 2014 and July 2015 on patients with PE who were referred to our medical center. In this study, the revised Geneva score, the original PESI scales, and the simplified PESI scales were utilized. Additionally, diagnostic and treatment procedures were done in accordance with the standard protocol. We collected data of patients including gender, age, any risk factors for venous thromboembolism. After the primary data collection, contacts were made to the patients or their relatives for gathering information about patient's survival. The mortality rates of patients were determined within 10 years after the PE.

Results: We analyzed data of 224 patients. Over a 131-month course of following up 224 patients, 105 deaths occurred that were related to PE. The initial PESI factor had a positive and negative predictive value of 83%. Patients with PE who scored extremely high on the PESI had a mortality and morbidity rate 42 times (9.22-87.32) greater than those with PE who scored very low. Furthermore, the death and morbidity rate of high-risk PE patients was 5% (0.67-1.70) in the Geneva score and 62% (0.30-2.31) in the simplified PESI score.

Conclusion: The use of original PESI score could predict the long-term mortality of PE patients more accurately than other scores.