Cardiology Fellow Lenox Hill Hospital - Northwell Health Lenox Hill Hospital - Northwell Health New York, New York, United States
Disclosure(s):
Atul D. Bali, MD FACC: No financial relationships to disclose
Background: Risk stratification models for acute pulmonary embolism (PE) are predict which patient is at risk for short-term adverse outcomes. We evaluate the predictive performance of the existing acute PE risk models (ESC classification, CPES and PESI) across the presenting SCAI Shock stages for PE patients complicated by cardiogenic shock (CS).
Methods: We identified patients in the Northwell Shock Registry who had CS secondary to PE. CPES, sPESI, and ESC scores were calculated and analyzed at each presenting SCAI stage in relation to a composite outcome of mortality or cardiac arrest. An ANOVA analysis was used to compare the variations of each individual scoring model across different SCAI stages.
Outcome: Our cohort included 98 patients, with a mean age was 64.2 ± 19.3 years of which 57% were females. 46% of patients had the composite outcome. Though not statistically significant, CPES scores were highest in SCAI Stages B and C, while sPESI and ESC scores showed lower variability across all stages. The composite outcome was most frequent at SCAI Stage E (63%).
Conclusion: Of the existing and evaluated risk stratification models, none of the scores demonstrated consistent predictive performance across presenting SCAI stages, highlighting the need for improved and expanded risk stratification tools in this high-risk disease state.
