• Am J Emerg Med · Oct 2017

    A novel clinical index for the assessment of RVD in acute pulmonary embolism: Blood pressure index.

    • Hale Ates, Ihsan Ates, Harun Kundi, Mehmet Fettah Arikan, and Fatma Meric Yilmaz.
    • Ankara Numune Training and Research Hospital, Department of Chest Disease, Ankara, Turkey. Electronic address: dr.haleates@hotmail.com.
    • Am J Emerg Med. 2017 Oct 1; 35 (10): 1400-1403.

    BackgroundThis study aims to investigate the role of the blood pressure index (BPI), which is a new index that we developed, in detection of right ventricular dysfunction (RVD) in acute pulmonary embolism (APE).MethodsA total of 539 patients, (253 males and 286 females), diagnosed with APE using computer tomography pulmonary angiography were included in the study. The BPI was obtained by dividing systolic blood pressure (SBP) by diastolic blood pressure (DBP).ResultsMean DBP (75±11mmHg vs 63±15mmHg; p<0.001, respectively) was found to be higher in RVD patients compared to those without RVD, whereas BPI (1.5±0.1 vs 1.9±0.2; p<0.001, respectively) was lower. Examining the performance of BPI in prediction of RVD using receiver operating characteristic curve analysis (area under curve±SE=0.975±0.006; p<0.001), it was found that BPI could predict RVD with very high sensitivity (92.8%) and specificity (100%) and had a positive predictive value of 100% and a negative predictive value of 42.1%. According to the analysis, the highest youden index for the optimal prediction value was found to be 0.478 and the BPI≤1.4 was found to predict mortality 68.6% sensitivity and 80.8% specificity (Area under curve±SE=0.777±0.051; p<0.001).ConclusionsWe found that BPI was an index with high positive predictive value and low negative predictive value in detection of RVD.Copyright © 2017 Elsevier Inc. All rights reserved.

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