A prospective validation of the Bova score in normotensive patients with acute pulmonary embolism
| Autor: | Loris Roncon, Enrico Bernardi, Alice Spinazzè, Deisy Barrios, Francesco Dentali, Fulvio Morello, Gabriele Viviani, Claudio Poggioni, Iolanda Enea, Sara Giatti, E. Bucherini, Fabrizio Bottino, Peiman Nazerian, Andrés Quezada, M. Vastola, Simone Vanni, L. Sardo, Sofia Barbar, Francesco Crocco, S. Barbar, G. De Morelli, A. Dall' Arche, S. Brescianini, F. Morello, Claudio Picariello, Nicola Mumoli, Raffaele Pesavento, Paolo Prandoni, Eugenio Bucherini, F. Stea, David Jiménez, Massimo Puato, I. Enea, Carlo Bova |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Hemodynamics 030204 cardiovascular system & hematology Risk Assessment 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Clinical endpoint Humans Female Prognosis Prospective Studies Pulmonary Embolism Hematology Stage (cooking) Prospective cohort study business.industry medicine.disease Confidence interval Pulmonary embolism Increased risk 030228 respiratory system Risk assessment business |
| Popis: | The Bova score has shown usefulness in the identification of intermediate-high risk patients with acute pulmonary embolism (PE), but lacks prospective validation. The aim of this study was to prospectively validate the Bova score in different settings from the original derivation cohort.Consecutive, normotensive patients with acute PE recruited at 13 academic or general hospitals were stratified, using their baseline data, into the three Bova risk stages (I-III). The primary outcome was the 30-day composite of PE-related mortality, hemodynamic collapse and non-fatal PE recurrences in the three risk categories.In the study period, 639 patients were enrolled. The primary end point occurred in 45 patients (7.0%; 95% Confidence Intervals, 5.2%-9.3%). Risk stage correlated with the PE-related complication rate (stage I, 2.9%; stage II, 17%; stage III, 27%). Patients classified as stage III by the Bova score had a 6.5-fold increased risk for adverse outcomes (3.1-13.5, p 0.001) compared with stages I and II combined. Rescue thrombolysis increased from stage I to stage III (0.6%, 12% and 15% respectively). All-cause mortality (5.3%) did not substantially differ among the stages.The Bova score accurately stratifies normotensive patients with acute PE into stages of increasing risk of 30-day PE-related complications. |
| Databáze: | OpenAIRE |
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