sPESI与PESI对于非高危急性肺栓塞患者危险分层结果的比较

目的 探究简化肺栓塞严重指数（sPESI）与肺栓塞严重指数（PESI）对于非高危急性肺栓塞患者危险分层结果是否有差异。方法 回顾性分析2015年1月~2017年12月自贡市第四人民医院非高危急性肺栓塞患者164例的临床资料，依照发病30天是否存活分为存活组154例，死亡组10例。计算PESI、sPESI，评价PESI与sPESI对于非高危急性肺栓塞患者危险分层结果的一致性及预测30天全因死亡率的准确性。结果 纳入研究患者共164例，年龄23~91岁，30天全因死亡10例，全因死亡率为6.10%。PESI、sPESI均为预测非高危急性肺栓塞30天全因死亡的危险因素。两种评分标准ROC比较，差异无统计学意义（P＞0.05），两种评分危险分层比较Kappa值0.626（P＜0.05）。结论 sPESI评分与PESI评分对于非高危急性肺栓塞30天全因死亡率预测的准确性及对非高危急性肺栓塞危险分层具有高度一致性，但本研究的纳入例数有限，有待更多数据研究支持。

Comparison of sPESI and PESI for Risk Stratification in Patients withNon-high-risk Acute Pulmonary Embolism

Abstract:Objective To investigate whether the Spiral Embolism Severity Index (sPESI) and Pulmonary Embolism Severity Index (PESI) are different for risk stratification in patients with non-high-risk acute pulmonary embolism.Methods The clinical data of 164 patients with non-high-risk acute pulmonary embolism from the Fourth People's Hospital of Zigong City from January 2015 to December 2017 were retrospectively analyzed. According to the survival of 30 days, 154 cases were in the survival group and 10 cases in the death group. PESI and sPESI were calculated to evaluate the consistency of PESI and sPESI for risk stratification in patients with non-high-risk acute pulmonary embolism and to predict the accuracy of 30-day all-cause mortality.Results A total of 164 patients were enrolled in the study, aged 23-91 years, with 10 deaths due to 30 days, and the all-cause mortality rate was 6.10%. Both PESI and sPESI were risk factors for predicting all-cause mortality in non-high-risk acute pulmonary embolism. There was no statistically significant difference between the two scoring criteria ROC(P>0.05), and the Kappa value of the two scores was 0.626 (P<0.05). Conclusion The score of sPESI and the score of PESI are highly consistent with the accuracy of 30-day all-cause mortality prediction for non-high-risk acute pulmonary embolism and the risk stratification for non-high-risk acute pulmonary embolism. However, the number of included cases in this study is limited and more data are needed to support the research.