A Study Of The Predictive Value Of TIMI Risk Index On 30 Day Mortality In Patients With Acute Pulmonary Embolism

Objective: The current literature on the TIMI risk index is mostly about the prognosis of acute myocardial infarction,especially in patients with STEMI,and its predictive ability has been confirmed.There are many similarities between the pathogenesis and clinical manifestations of acute myocardial infarction and acute pulmonary embolism.The purpose of this study is to use the TIMI risk index for 3 of the patients with acute pulmonary embolism.Predictive assessment of 0 day mortality.Methods: Review observational study.Acute pulmonary embolism aged> 18 years diagnosed by CTPA was collected at the emergency department of the First Affiliated Hospital of Xinjiang Medical University from June 2014 to June 2017.In this study,we used the ESC stratification as a reference,and then evaluated the TIMI risk index to evaluate the predictive value of TIMI risk index for 30-day mortality in patients with different ESC stratified acute PTE,and compared with the commonly used sPESI score and WELLs score..Results:(1)The distribution or change trend of heart rate,blood pressure,RVD,biomarker positive rate,SaO2,sPESI score score in the ESC risk stratification and the TIMI risk index four quantiles were all the same,and the two were similar in the regularity.(2)The TIMI risk index(AUC0.878,95%CI0.823-0.932,P=0.000)and sPESI score(AUC0.709,95%CI0.604-0.815,P=0.000)had statistical significance for the prediction of patients with acute pulmonary embolism 30 day mortality,and the predictive ability of the TIMI risk index is higher than the sPESI score(Z=2.778,P<0.001);the WELLs score of the predictive ability was not statistically significant(AUC0.537.95%CI0.418-0.657,P=0.522).(3)The TIMI risk index of low risk(AUC0.976,95%CI0.000-1.000,P=0.002),intermediate(AUC0.945,95%CI0.000-1.000,P=0.001)and high risk group(AUC0.945,95%CI0.000-1.000,P=0.001)is a predictor of acute pulmonary embolism in 30 day mortality,no predictive effect on the high risk group(AUC0.589,95%CI0.378-0.800,P=0.426).Conclusion:(1)The TIMI risk index in patients with acute PTE 30 day all-cause mortality have predictive value,the cutoff value was 41.09,the TIMI risk index is greater than or equal to 41.09 groups of the 30 day prognosis than < 41.09 groups of poor prognosis.(2)The TIMI risk index has a good predictive effect on the 30 day mortality of patients with acute PTE in low,middle and high risk groups.The sensitivity and specificity are high,but it is not predictive for high-risk group.(3)The TIMI risk index is better than the sPESI score in predicting the 30 day mortality rate of acute PTE,while the WELLs score has no predictive ability for the30 day mortality of acute PTE.