GIÁ TRỊ TIÊN LƯỢNG CỦA CHỈ SỐ SỐC THEO TUỔI TRONG PHÂN TẦNG NGUY CƠ TỬ VONG TRÊN BỆNH NHÂN THUYÊN TẮC PHỔI CẤP HUYẾT ĐỘNG ỔN ĐỊNH

Abstract

Background: Acute pulmonary embolism (PE) is a common disease in the world and the mortality rate is still high. The world has a growing trend of active intervention in hemodynamically stable patients, so age shock index (ASI), with high sensitivity to the early stage of shock, can contribute to risk stratification in hemodynamically stable patients with PE. Objective: Determine AUC, the optimal cut-off point for ASI to predict mortality in hemodynamically stable patients with PE. Patients and methods: A retrospective cross-sectional study with analysis of 147 hemodynamically stable PE patients. Results: The average age of the study population is 63.09±1.50 years old with female ratio 1.94 times higher than male. The mortality rate in hemodynamically stable patients with PE is 12.9%. Mortality risk factors are heart rate (OR=1.03; 95%CI: 1.00 – 1.06; p=0.042), shock index (OR=8.88; 95%CI: 1.00 – 78.68; p=0.049), and ASI (OR=1.03; 95%CI: 1.01 – 1.06; p=0.007). ASI model is a good prediction tool for predicting short-term mortality risk with AUC = 0.731 (95%CI: 0.624 – 0.839, p=0.001), the optimal cut-off point is 72.0, sensitivity is 63.2%, specificity is 79.7%, PPV is 31.6%, and NPV is 93.6%. Conclusion: ASI, is a good prediction tool for predicting short-term mortality risk, with its simplicity, and ease of clinical application will support to the ESC risk stratification tool and reduce the application gap of PESI and sPESI.