• Anna M Imiela, Elżbieta Kozak-Szkopek, Monika Szymańska, Katarzyna Wdowiak, Olga Dzikowska-Diduch, Aleksandra Żuk-Łapan, Andrzej Pruszczyk, Izabela Bukalska, Karolina Niewczas, Michał Machowski, Aisha Ou-Pokrzewińska, and Piotr Pruszczyk.
• Department of Internal Diseases and Cardiology, Centre for Management of Venous Thromboembolic Disease, Medical University of Warsaw, Warsaw, Poland. anna.imiela@wum.edu.pl
• Pol. Arch. Med. Wewn. 2024 Apr 26; 134 (4).

IntroductionAcute pulmonary embolism (APE) is the most serious manifestation of venous thromboembolism. The simplified Pulmonary Embolism Severity Index (sPESI) is employed for prediction of 30-day mortality in APE. The Vulnerable Elders Survey (VES-13) is used to identify participants at a risk of health impairment.ObjectivesWe aimed to compare the VES-13 and sPESI scales for prediction of 3-month mortality inelderly patients hospitalized for APE.Patients And MethodsAll patients with APE were managed according to the European Society of Cardiology (ESC) guidelines and followed up for at least 3 months after discharge. Clinical evaluation of all patients involved the Charlson Comorbidity Index (CCI) and biochemical tests. The patients with VES-13 score equal to or above 3 (VES-13≥3) were evaluated with comprehensive geriatric assessment (CGA).ResultsA total of 164 patients met the inclusion criteria. There were significantly fewer men in the VES-13≥3 than the VES-13<3 group (34% vs 54.5%; P <0.01). The patients in the VES-13≥3 group had lower median (interquartile range [IQR]) body mass index and higher sPESI score than those in the VES-13<3 group (25.6 [21.8-28.4] kg/m2 vs 28 [25.3-31] kg/m2; P = 0.001 and 2 [1-2] points vs 1 [0-1] point; P <0.001, respectively). There were no differences in APE severity according to the ESC stratification and CCI. Logistic regression analysis identified the VES-13 score as a significant independent risk factor for 3-month mortality.ConclusionsThe VES-13 score is a better tool than sPESI for predicting 3-month mortality. Geriatric survivors of APE characterized with VES-13≥3 points should be closely monitored after discharge. The Norton Scale Score in a combination with the VES-13 may be useful in predicting 3-month mortality among numerous tests used in the CGA.

23 keywords...

hide…