Combination Of Simple Pulmonary Embolism Severity Index And High-sensitivity Troponin T For The Assessment Of The Short-term Prognosis In Hemodynamically Stable Patients With Acute Pulmonary Embolism

ObjectiveTo evaluate the Short-term prognostic value of the simplfied Pulmonary Embolism Severity Index (SPESI) and high-sensitivity troponin T (hs-TnT) in hemodynamically stable patients with acute pulmonary embolism (APE), and evaluate if their joint is better than used alone, producing a better prediction accuracy.MethodsNinety-nine consecutive hemodynamically stable patients with acute pulmonary embolism from the Second Affiliated Hospital of Kunming Medical University were enrolled. The plasma concentration of hs-TnT was analyzed and the sPESI scores were calculated. According to the SPESI score, patients were divided into high-risk group (SPESI score≥1 point) and low risk group (SPESI score=0 point);according to hs-TnT,patients were divided into positive group (hs-TnT≥0.014ng/ml) and negative group (hs-TnT<0.014ng/ml), and then unite the two Grouping methods. Observe the number of adverse events in each group after standard treatment and thirty-day clinical follow-up, and then calculate the packet prediction of adverse events sensitivity, specificity degree,positive predictive value,negative predictive value.and draw ROC curve to evaluate the values of different grouping methods for evaluating the prognosis.Results A total of 13 adverse events appered within 30 days. The single test showes:hs-TnT for predicting sensitivity adverse events within 30 days is 84.6%, specificity is 55.2%, positive predictive value is 22%, negative predictive value is 96%. alone on SPESI with predictive sensitivity is 92.3%, specificity is 48.8%, positive predictive value is 21.1%, negative predictive value is 97.7%. combination of the two joint test shows: sensitivity is 100%, specificity is 29%, positive predictive value is 17.6%, negative predictive value is 100%. Draw the ROC curve separately according to the three evaluation modes above, and calculate the area under the curve(AUC):SPESI AUC= 0.832(95% CI,0.705-0.958), hs-TnT AUC=0.825 (95%CI,0.694-0.957), SPESI combined with hs-TnT AUC=0.872 (95%CI,0.773-0.971).Conclusion1.SPESI and hs-TnT have a certain value in the assessment of the prognosis in hemodynamically stable patients with pulmonary embolism.2.SPESI combined with hs-TnT assessment of prognostic value is superior to the use of a single,in particular,to identify low-risk patients with significant value.