Description and efficacy of the main prognostic algorithms for the identification of low- and high-risk patients with pulmonary embolism
| Algorithm . | Reference . | No. of clinical items in the model . | Instrumental tests in the model . | Fixed value for items in the model . | Low-risk patients according to the model . | Validation . | Management study . | |
|---|---|---|---|---|---|---|---|---|
| Prevalence . | 30-d mortality (95% CI) . | |||||||
| Simplified FAST | 21 | 2 | H-FABP | No | 22 | 1 (0.1-14)* | No | No |
| ESC 2008 | 22 | 1† | RVD,‡ troponin | na | 17 | 0 (na) | Yes | No |
| ESC 2014 | 23 | 7§ | RVD,|| biomarkers¶ | na | 22 | 0.5 (0-1.5) | Yes | No |
| PREP | 24 | 3 | RVD at echo, BNP | No | 68 | 2.5 (1.2-4.9)* | No | No |
| eStiMaTe# (normotensive) | 25 | 6 | Troponin, BNP | Yes | 36.5 | 0 (na) | Yes | No |
| Normotensive | 26 | 2 | RVD,|| troponin | No | 75.5 | 3.1 (2.1-4.5)** | Yes | No |
| Algorithm . | Reference . | No. of clinical items in the model . | Instrumental tests in the model . | Fixed value for items in the model . | Low-risk patients according to the model . | Validation . | Management study . | |
|---|---|---|---|---|---|---|---|---|
| Prevalence . | 30-d mortality (95% CI) . | |||||||
| Simplified FAST | 21 | 2 | H-FABP | No | 22 | 1 (0.1-14)* | No | No |
| ESC 2008 | 22 | 1† | RVD,‡ troponin | na | 17 | 0 (na) | Yes | No |
| ESC 2014 | 23 | 7§ | RVD,|| biomarkers¶ | na | 22 | 0.5 (0-1.5) | Yes | No |
| PREP | 24 | 3 | RVD at echo, BNP | No | 68 | 2.5 (1.2-4.9)* | No | No |
| eStiMaTe# (normotensive) | 25 | 6 | Troponin, BNP | Yes | 36.5 | 0 (na) | Yes | No |
| Normotensive | 26 | 2 | RVD,|| troponin | No | 75.5 | 3.1 (2.1-4.5)** | Yes | No |
ESC, European Society of Cardiology; FAST, H-FABP-Syncope-Tachicardia; H-FABP, heart-type fatty acid-binding protein; RVD, right ventricular dysfunction.
Rate of death or cardiogenic shock or objectively confirmed recurrent venous thromboembolism.
Hemodynamic status.
The right ventricle assessment can be done at echocardiography or by BNP.
PESI or sPESI and hemodynamic status.
Right ventricle dysfunction can be assessed by either echocardiography or CT angiography.
Troponin and/or BNP.
Also includes lower limbs ultrasonography.
PE-related mortality.