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Título

A clinical prognostic model for the identification of low-risk patients with acute symptomatic pulmonary embolism and active cancer

Autorden Exter, Paul L.; Gómez, Vicente; Jiménez, David; Trujillo-Santos, Javier; Muriel, Alfonso; Huisman, Menno V.; Monreal, Manuel
Fecha de publicaciónene-2013
EditorElsevier
CitaciónChest 173(1): 138–145 (2013)
Resumen[Background] Physicians need a specific risk-stratification tool to facilitate safe and cost-effective approaches to the management of patients with cancer and acute pulmonary embolism (PE). The objective of this study was to develop a simple risk score for predicting 30-day mortality in patients with PE and cancer by using measures readily obtained at the time of PE diagnosis.
[Methods] Investigators randomly allocated 1,556 consecutive patients with cancer and acute PE from the international multicenter Registro Informatizado de la Enfermedad TromboEmbólica to derivation (67%) and internal validation (33%) samples. The external validation cohort for this study consisted of 261 patients with cancer and acute PE. Investigators compared 30-day all-cause mortality and nonfatal adverse medical outcomes across the derivation and two validation samples.
[Results] In the derivation sample, multivariable analyses produced the risk score, which contained six variables: age > 80 years, heart rate ≥ 110/min, systolic BP < 100 mm Hg, body weight < 60 kg, recent immobility, and presence of metastases. In the internal validation cohort (n = 508), the 22.2% of patients (113 of 508) classified as low risk by the prognostic model had a 30-day mortality of 4.4% (95% CI, 0.6%–8.2%) compared with 29.9% (95% CI, 25.4%–34.4%) in the high-risk group. In the external validation cohort, the 18% of patients (47 of 261) classified as low risk by the prognostic model had a 30-day mortality of 0%, compared with 19.6% (95% CI, 14.3%–25.0%) in the high-risk group.
[Conclusions] The developed clinical prediction rule accurately identifies low-risk patients with cancer and acute PE.
Versión del editorhttp://doi.org/10.1378/chest.12-0964
URIhttp://hdl.handle.net/10261/142739
DOI10.1378/chest.12-0964
Identificadoresissn: 0012-3692
e-issn: 1931-3543
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