Predictors of early death in patients with acute pulmonary embolism

Akgüllü, Çağdaş; Ömürlü, İmran Kurt; Eryılmaz, Ufuk; Avcil, Mücahit; Dağtekin, Evrin; Akdeniz, Mehmet; Güngör, Hasan; Zencir, Cemil

doi:10.1016/j.ajem.2014.11.022

Cited by 42 publications

(32 citation statements)

References 35 publications

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“…15 We found that high NLR at baseline was associated with increased risk of mortality among the subjects who later experienced a VTE. The mechanism for the increased risk of mortality by high NLR in VTE patients is unclear.…”

Section: Letters To the Editormentioning

confidence: 83%

Neutrophil to lymphocyte ratio and future risk of venous thromboembolism and mortality: the Tromso Study

et al. 2016

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Section: Letters To the Editormentioning

confidence: 83%

Neutrophil to lymphocyte ratio and future risk of venous thromboembolism and mortality: the Tromso Study

et al. 2016

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“…Twenty studies (4898 patients) reported data on in‐hospital mortality . Several ECG features were meta‐analyzed for this outcome (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…Some studies reported continuous ECG measures as predictors of in‐hospital mortality. Akgullu et al looked at QT‐interval dispersion and P‐wave dispersion and found that patients who died had a longer dispersion for both measures (median and interquartile range [IQR]: 104 [97–119] vs 78 [68–84], and 73 [54–79] vs 48 [35–55], respectively; P < 0.001 for both). Ermis and colleagues investigated QT‐interval dispersion and also found a longer mean (SD) dispersion in the group that died (89 [46] vs 65 [23]; P = 0.001).…”

Section: Resultsmentioning

confidence: 99%

“…Since the publication of the Daniel score, several other studies have investigated the use of ECG as a tool for PE prognostication. These studies expanded the use of ECG and included findings not included in the Daniel score, such as ST‐segment depression, ST‐segment elevation (STE), Qr in lead V 1 , right axis deviation (RAD), and P pulmonale, among others . A recent consensus article by the International Society of Electrocardiology, the International Society for Holter and Noninvasive Electrocardiology, and the Iberoamerican Forum of Arrhythmias in the Internet demonstrated the need for a formal and comprehensive evaluation of the evidence for the use of ECG to prognosticate PE …”

Section: Introductionmentioning

confidence: 99%

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The value of electrocardiography in prognosticating clinical deterioration and mortality in acute pulmonary embolism: A systematic review and meta‐analysis

Qaddoura

Digby

Kabali

et al. 2017

Clinical Cardiology

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The role of electrocardiography (ECG) in prognosticating pulmonary embolism (PE) is increasingly recognized. ECG is quickly interpretable, noninvasive, inexpensive, and available in remote areas.We hypothesized that ECG can provide useful information about PE prognostication. We searched MEDLINE, EMBASE, Google Scholar, Web of Science, abstracts, conference proceedings, and reference lists through February 2017. Eligible studies used ECG to prognosticate for the main outcomes of death and clinical deterioration or escalation of therapy. Two authors independently selected studies; disagreement was resolved by consensus. Ad hoc piloted forms were used to extract data and assess risk of bias. We used a random-effects model to pool relevant data in meta-analysis with odds ratios (ORs) and 95% confidence intervals (CIs); all other data were synthesized qualitatively. Statistical heterogeneity was assessed using the I 2 value. We included 39 studies (9198 patients) in the systematic review. There was agreement in study selection (κ:0.91, 95% CI: 0.86-0.96). Most studies were retrospective; some did not appropriately control for confounders. ECG signs that were good predictors of a negative outcome included S1Q3T3 (OR:3.38, 95% CI: 2.46-4.66, P < 0.001), complete right bundle branch block (OR: 3.90, 95% CI: 2.46-6.20, P < 0.001), T-wave inversion (OR: 1.62, 95% CI: 1.19-2.21, P = 0.002), right axis deviation (OR: 3.24, 95% CI: 1.86-5.64, P < 0.001), and atrial fibrillation (OR: 1.96, 95% CI: 1.45-2.67, P < 0.001) for in-hospital mortality. Several ischemic patterns also were significantly predictive.Our conclusion is that ECG is potentially valuable in prognostication of acute PE.

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“…These indicators have been used increasingly as new prognostic markers for risk predication of cardiovascular disease and cancers [11–14]. Limited studies have explored the predicative abilities of NLR and PLR on short-term mortality among patients with acute PE [11, 15, 16]. However, some important confounding was not controlled in analysis and the predicative abilities of NLR and PLR was not fully assessed.…”

Section: Introductionmentioning

confidence: 99%

The values of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in predicting 30 day mortality in patients with acute pulmonary embolism

Mao

et al. 2016

BMC Cardiovasc Disord

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BackgroundvAcute pulmonary embolism (PE) is a life threatening disease. The treatment options depend on the severity of the disease and the mortality varies widely depending on the severity of the condition. It is important to identify patients who are at high risk of mortality. The aim of the present study was to explore the prognostic alues of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) for 30-day mortality in patients with acute PE.MethodsThe study included 321 patients admitted to our university hospital between January 2013 and May 2015 with the diagnosis of acute PE. Multivariable risk models were developed to assess the predictive values of the NLR and PLR for 30-day mortality. Discrimination was evaluated using receiver operating characteristic (ROC) curves.ResultsTwo hundred forty-eight patients met our selection criteria. Twenty of them died within 30 days of hospital admission. NLR was found to be an independent predicator after other confounding factors were adjusted in the model. For 1 unit of increase of NLR, the risk of 30-day mortality rose about 13 % (OR = 1.13,95 % CI: 1.04–1.23). The area under ROC for NLR is 0.79 (95 %CI: 0.703–0.880). PLR was associated with 30-day mortality in univariate analysis but the predicative ability diminished with inclusion of other predicators in multivariable model.ConclusionsNLR is readily available predicator for short-term mortality. It could be a useful indicator for identifying high risk population and guiding clinical management of acute PE.

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Predictors of early death in patients with acute pulmonary embolism

Cited by 42 publications

References 35 publications

Neutrophil to lymphocyte ratio and future risk of venous thromboembolism and mortality: the Tromso Study

Neutrophil to lymphocyte ratio and future risk of venous thromboembolism and mortality: the Tromso Study

The value of electrocardiography in prognosticating clinical deterioration and mortality in acute pulmonary embolism: A systematic review and meta‐analysis

The values of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in predicting 30 day mortality in patients with acute pulmonary embolism

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