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CRB-65 for Risk Stratification and Prediction of Prognosis in Pulmonary Embolism

Background: Pulmonary embolism (PE) is accompanied by high morbidity and mortality. The search for simple and easily assessable risk stratification scores with favourable effectiveness is still ongoing, and prognostic performance of the CRB-65 score in PE might promising. Methods: The German nationw...

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Autores principales: Keller, Karsten, Schmitt, Volker H., Sagoschen, Ingo, Münzel, Thomas, Espinola-Klein, Christine, Hobohm, Lukas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9961795/
https://www.ncbi.nlm.nih.gov/pubmed/36835800
http://dx.doi.org/10.3390/jcm12041264
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author Keller, Karsten
Schmitt, Volker H.
Sagoschen, Ingo
Münzel, Thomas
Espinola-Klein, Christine
Hobohm, Lukas
author_facet Keller, Karsten
Schmitt, Volker H.
Sagoschen, Ingo
Münzel, Thomas
Espinola-Klein, Christine
Hobohm, Lukas
author_sort Keller, Karsten
collection PubMed
description Background: Pulmonary embolism (PE) is accompanied by high morbidity and mortality. The search for simple and easily assessable risk stratification scores with favourable effectiveness is still ongoing, and prognostic performance of the CRB-65 score in PE might promising. Methods: The German nationwide inpatient sample was used for this study. All patient cases of patients with PE in Germany 2005–2020 were included and stratified for CRB-65 risk class: low-risk group (CRB-65-score 0 points) vs. high-risk group (CRB-65-score ≥1 points). Results: Overall, 1,373,145 patient cases of patients with PE (76.6% aged ≥65 years, 47.0% females) were included. Among these, 1,051,244 patient cases (76.6%) were classified as high-risk according to CRB-65 score (≥1 points). The majority of high-risk patients according to CRB-65 score were females (55.8%). Additionally, high-risk patients according to CRB-65 score showed an aggravated comorbidity profile with increased Charlson comorbidity index (5.0 [IQR 4.0–7.0] vs. 2.0 [0.0–3.0], p < 0.001). In-hospital case fatality (19.0% vs. 3.4%, p < 0.001) and MACCE (22.4% vs. 5.1%, p < 0.001) occurred distinctly more often in PE patients of the high-risk group according to CRB-65 score (≥1 points) compared to the low-risk group (= 0 points). The CRB-65 high-risk class was independently associated with in-hospital death (OR 5.53 [95%CI 5.40–5.65], p < 0.001) as well as MACCE (OR 4.31 [95%CI 4.23–4.40], p < 0.001). Conclusions: Risk stratification with CRB-65 score was helpful for identifying PE patients being at higher risk of adverse in-hospital events. The high-risk class according to CRB-65 score (≥1 points) was independently associated with a 5.5-fold increased occurrence of in-hospital death.
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spelling pubmed-99617952023-02-26 CRB-65 for Risk Stratification and Prediction of Prognosis in Pulmonary Embolism Keller, Karsten Schmitt, Volker H. Sagoschen, Ingo Münzel, Thomas Espinola-Klein, Christine Hobohm, Lukas J Clin Med Article Background: Pulmonary embolism (PE) is accompanied by high morbidity and mortality. The search for simple and easily assessable risk stratification scores with favourable effectiveness is still ongoing, and prognostic performance of the CRB-65 score in PE might promising. Methods: The German nationwide inpatient sample was used for this study. All patient cases of patients with PE in Germany 2005–2020 were included and stratified for CRB-65 risk class: low-risk group (CRB-65-score 0 points) vs. high-risk group (CRB-65-score ≥1 points). Results: Overall, 1,373,145 patient cases of patients with PE (76.6% aged ≥65 years, 47.0% females) were included. Among these, 1,051,244 patient cases (76.6%) were classified as high-risk according to CRB-65 score (≥1 points). The majority of high-risk patients according to CRB-65 score were females (55.8%). Additionally, high-risk patients according to CRB-65 score showed an aggravated comorbidity profile with increased Charlson comorbidity index (5.0 [IQR 4.0–7.0] vs. 2.0 [0.0–3.0], p < 0.001). In-hospital case fatality (19.0% vs. 3.4%, p < 0.001) and MACCE (22.4% vs. 5.1%, p < 0.001) occurred distinctly more often in PE patients of the high-risk group according to CRB-65 score (≥1 points) compared to the low-risk group (= 0 points). The CRB-65 high-risk class was independently associated with in-hospital death (OR 5.53 [95%CI 5.40–5.65], p < 0.001) as well as MACCE (OR 4.31 [95%CI 4.23–4.40], p < 0.001). Conclusions: Risk stratification with CRB-65 score was helpful for identifying PE patients being at higher risk of adverse in-hospital events. The high-risk class according to CRB-65 score (≥1 points) was independently associated with a 5.5-fold increased occurrence of in-hospital death. MDPI 2023-02-05 /pmc/articles/PMC9961795/ /pubmed/36835800 http://dx.doi.org/10.3390/jcm12041264 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Keller, Karsten
Schmitt, Volker H.
Sagoschen, Ingo
Münzel, Thomas
Espinola-Klein, Christine
Hobohm, Lukas
CRB-65 for Risk Stratification and Prediction of Prognosis in Pulmonary Embolism
title CRB-65 for Risk Stratification and Prediction of Prognosis in Pulmonary Embolism
title_full CRB-65 for Risk Stratification and Prediction of Prognosis in Pulmonary Embolism
title_fullStr CRB-65 for Risk Stratification and Prediction of Prognosis in Pulmonary Embolism
title_full_unstemmed CRB-65 for Risk Stratification and Prediction of Prognosis in Pulmonary Embolism
title_short CRB-65 for Risk Stratification and Prediction of Prognosis in Pulmonary Embolism
title_sort crb-65 for risk stratification and prediction of prognosis in pulmonary embolism
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9961795/
https://www.ncbi.nlm.nih.gov/pubmed/36835800
http://dx.doi.org/10.3390/jcm12041264
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