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Pulmonary Embolism Severity Index Predicts Adverse Events in Hospitalized COVID-19 Patients: A Retrospective Observational Study

OBJECTIVES: Pulmonary embolism is one of the leading causes of death in patients with COVID-19. Autopsy findings showed that the incidence of thromboembolic events was higher than clinically suspected. In this study, the authors investigated the relationship between pulmonary embolism severity index...

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Autores principales: Kalaycı, Süleyman, Köksal, Bengü Gülhan, Horuz, Emre, Ertem, Evşen, Cömert, Füsun, Somuncu, Mustafa Umut, Kalaycı, Belma
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9391081/
https://www.ncbi.nlm.nih.gov/pubmed/36155716
http://dx.doi.org/10.1053/j.jvca.2022.08.009
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author Kalaycı, Süleyman
Köksal, Bengü Gülhan
Horuz, Emre
Ertem, Evşen
Cömert, Füsun
Somuncu, Mustafa Umut
Kalaycı, Belma
author_facet Kalaycı, Süleyman
Köksal, Bengü Gülhan
Horuz, Emre
Ertem, Evşen
Cömert, Füsun
Somuncu, Mustafa Umut
Kalaycı, Belma
author_sort Kalaycı, Süleyman
collection PubMed
description OBJECTIVES: Pulmonary embolism is one of the leading causes of death in patients with COVID-19. Autopsy findings showed that the incidence of thromboembolic events was higher than clinically suspected. In this study, the authors investigated the relationship between pulmonary embolism severity index (PESI) and simplified PESI (sPESI) on admission to the hospital, as well as adverse events in hospitalized COVID-19 patients without clinically documented venous and/or pulmonary embolism. The adverse events investigated were the development of acute respiratory distress syndrome, the need for intensive care unit admission, invasive or noninvasive mechanical ventilation, and in-hospital mortality. DESIGN: A retrospective and observational study. SETTING: Two large-volume tertiary hospitals in the same city. PARTICIPANTS: A total of 720 hospitalized COVID-19 patients with a positive polymerase chain reaction were evaluated. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of the study population, 48.6% (350) were women, and the median age was 66 years (19-96). The overall in-hospital mortality rate was 20.5%. In the multivariate logistic regression analysis, a significant relationship was found between the whole adverse events considered and PESI, as well as sPESI (p < 0.001). According to the results, sPESI ≥2 predicts in-hospital mortality with a sensitivity of 61.4% and specificity of 83.3% (area under the curve = 0.817, 95% confidence interval 0.787-0.845, p < 0.001). Similarly, PESI classes IV and V also were found as independent risk factors for in-hospital mortality (for PESI class IV, odds ratio = 2.81, p < 0.017; for PESI class V, odds ratio = 3.94, p < 0.001). CONCLUSIONS: PESI and sPESI scoring systems were both found to be associated with adverse events, and they can be used to predict in-hospital mortality in hospitalized COVID-19 patients without documented venous and/or pulmonary embolism.
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spelling pubmed-93910812022-08-22 Pulmonary Embolism Severity Index Predicts Adverse Events in Hospitalized COVID-19 Patients: A Retrospective Observational Study Kalaycı, Süleyman Köksal, Bengü Gülhan Horuz, Emre Ertem, Evşen Cömert, Füsun Somuncu, Mustafa Umut Kalaycı, Belma J Cardiothorac Vasc Anesth Original Article OBJECTIVES: Pulmonary embolism is one of the leading causes of death in patients with COVID-19. Autopsy findings showed that the incidence of thromboembolic events was higher than clinically suspected. In this study, the authors investigated the relationship between pulmonary embolism severity index (PESI) and simplified PESI (sPESI) on admission to the hospital, as well as adverse events in hospitalized COVID-19 patients without clinically documented venous and/or pulmonary embolism. The adverse events investigated were the development of acute respiratory distress syndrome, the need for intensive care unit admission, invasive or noninvasive mechanical ventilation, and in-hospital mortality. DESIGN: A retrospective and observational study. SETTING: Two large-volume tertiary hospitals in the same city. PARTICIPANTS: A total of 720 hospitalized COVID-19 patients with a positive polymerase chain reaction were evaluated. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of the study population, 48.6% (350) were women, and the median age was 66 years (19-96). The overall in-hospital mortality rate was 20.5%. In the multivariate logistic regression analysis, a significant relationship was found between the whole adverse events considered and PESI, as well as sPESI (p < 0.001). According to the results, sPESI ≥2 predicts in-hospital mortality with a sensitivity of 61.4% and specificity of 83.3% (area under the curve = 0.817, 95% confidence interval 0.787-0.845, p < 0.001). Similarly, PESI classes IV and V also were found as independent risk factors for in-hospital mortality (for PESI class IV, odds ratio = 2.81, p < 0.017; for PESI class V, odds ratio = 3.94, p < 0.001). CONCLUSIONS: PESI and sPESI scoring systems were both found to be associated with adverse events, and they can be used to predict in-hospital mortality in hospitalized COVID-19 patients without documented venous and/or pulmonary embolism. Elsevier Inc. 2022-12 2022-08-20 /pmc/articles/PMC9391081/ /pubmed/36155716 http://dx.doi.org/10.1053/j.jvca.2022.08.009 Text en © 2022 Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Original Article
Kalaycı, Süleyman
Köksal, Bengü Gülhan
Horuz, Emre
Ertem, Evşen
Cömert, Füsun
Somuncu, Mustafa Umut
Kalaycı, Belma
Pulmonary Embolism Severity Index Predicts Adverse Events in Hospitalized COVID-19 Patients: A Retrospective Observational Study
title Pulmonary Embolism Severity Index Predicts Adverse Events in Hospitalized COVID-19 Patients: A Retrospective Observational Study
title_full Pulmonary Embolism Severity Index Predicts Adverse Events in Hospitalized COVID-19 Patients: A Retrospective Observational Study
title_fullStr Pulmonary Embolism Severity Index Predicts Adverse Events in Hospitalized COVID-19 Patients: A Retrospective Observational Study
title_full_unstemmed Pulmonary Embolism Severity Index Predicts Adverse Events in Hospitalized COVID-19 Patients: A Retrospective Observational Study
title_short Pulmonary Embolism Severity Index Predicts Adverse Events in Hospitalized COVID-19 Patients: A Retrospective Observational Study
title_sort pulmonary embolism severity index predicts adverse events in hospitalized covid-19 patients: a retrospective observational study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9391081/
https://www.ncbi.nlm.nih.gov/pubmed/36155716
http://dx.doi.org/10.1053/j.jvca.2022.08.009
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