Predictive Value of Wells, Geneva, Bova, and PESI Scores in Elderly Pulmonary Embolism Patients.

Abstract

BACKGROUND This retrospective study aimed to compare the Wells score, Geneva score, Bova score, and Pulmonary Embolism Severity Index (PESI) in the prediction of 30-day mortality and survival outcomes in 200 geriatric patients with a diagnosis of pulmonary embolism (PE). MATERIAL AND METHODS We reviewed the records of 200 patients (≥65 years old) admitted to the Emergency Department between May 2019 and December 2019 with a diagnosis of PE confirmed by computed tomography pulmonary angiography. Demographic variables, comorbidities, mental status, and laboratory data were collected. The Wells score, Geneva score, Bova score, and PESI were calculated for each patient. Primary outcome was 30-day mortality. RESULTS Among these 200 elderly patients, the presence of malignancy (P<0.05) and altered mental status (P<0.05) were significantly associated with 30-day mortality. When analyzed categorically, only the PESI score showed a significant relationship with mortality (P<0.05). However, when considering numeric values, the Bova (P<0.001), Geneva (P=0.028), and PESI (P<0.001) scores all significantly predicted 30-day mortality. CONCLUSIONS The findings suggest that PESI alone is a strong predictor of short-term mortality when evaluated categorically, while Bova, Geneva, and PESI scores provide significant prognostic information in numeric form. This underscores the importance of detailed scoring in identifying high-risk older patients with PE, which can guide treatment decisions and potentially improve clinical outcomes.