Login
Search
Search
0 Dates
2026
2025
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
CPC 2025
CPC 2026
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
When sPESI Falls Short: The msPESI Raises the Bar in Pulmonary Embolism Risk Stratification
Session:
Sessão de Posters 27 - Abordagem e avanços terapêuticos na hipertensão pulmonar
Speaker:
Rita Figueiredo
Congress:
CPC 2026
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
Subtheme:
21.2 Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Ana Rita M. Figueiredo; Marta Vilela; Daniel Inácio Cazeiro; Diogo Ferreira; João Cravo; Sofia Esteves; João Reis Sabido; Fausto J. Pinto; João Ribeiro; Doroteia Silva
Abstract
<p style="text-align:justify"><strong>Background</strong>:</p> <p style="text-align:justify">Pulmonary embolism (PE) remains a major cause of in-hospital mortality in Intensive Care Units (ICUs). Existing prognostic models often fail to accurately identify patients at highest risk who may benefit from intensified management. This study aimed to identify independent predictors of poor prognosis and to develop a modified predictive score for patients with intermediate-high and high-risk PE.</p> <p style="text-align:justify"><strong>Methods</strong>:</p> <p style="text-align:justify">This retrospective, observational, single-center study included patients with intermediate-high or high-risk PE (according to the ESC guidelines) admitted to the ICU between 2020 and 2024. Independent predictors of outcomes were identified using multivariate Cox regression analysis. The simplified Pulmonary Embolism Severity Index (sPESI) was modified to create a new model, the modified sPESI (msPESI), which was then compared with the original sPESI for prognostic performance.</p> <p style="text-align:justify"><strong>Results</strong>:</p> <p style="text-align:justify">A total of 87 patients were included (mean age 56±17 years, 52% female).Comorbidities included previous PE (8%), prior venous thromboembolism (9%), cancer (21%), thrombophilia (16%) and recent bed rest (30%). On admission, mean hemoglobin was 12.1±2.9 g/dL, median troponin T was 85 [170] ng/L, median NT-proBNP 2560 [5508] pg/mL, and median lactate 22.0 [38.8] mg/dL. Only 1 patient had sPESI=0, all others had sPESI≥1. Regarding reperfusion therapies, 43% patients received fibrinolysis and 5% underwent thrombectomy. During ICU stay, 63% patients developed obstructive shock, 33% had cardiac arrest, 9% required extracorporeal membrane oxygenation, 25% experienced major bleeding and 32% died.</p> <p style="text-align:justify">Higher sPESI scores were independently associated with 30-day mortality (HR 1.774, 95% CI 1.079-2.918, p=0.024). In multivariate analysis (adjusted for age, sex, NT-proBNP and troponin), lactate (HR 1.014, 95% CI 1.006-1.022; p<0.001) and hemoglobin at admission (HR 0.762, 95% CI 0.649-0.898; p=0.001) were independent predictors of events. Based on these results, the msPESI was developed using variables readily obtained from arterial blood gas analysis: msPESI = 0.573 * sPESI + 0.014 * Lactate (mg/dL) – 0.272 * [Hb (g/dL) – 13] + 0.35.<br /> The msPESI outperformed sPESI in predicting 30-day mortality (AUC 0.854 vs. 0.741). The optimal cut-off value was msPESI = 2.5, yielding 89% sensitivity and 66% specificity. Patients with an msPESI > 2.5 had a 7.6-fold higher risk of 30-day mortality (HR 7.651, 95% CI 2.639-22.185, p<0.001) and higher msPESI scores strongly correlated with increased mortality (HR 2.298, 95% CI 1.752-3.016, p<0.001).</p> <p style="text-align:justify"><strong>Conclusions</strong>:</p> <p style="text-align:justify">The msPESI showed significantly better performance than the original sPESI in predicting short-term mortality among critically ill patients with PE. As a simple tool integrating two readily accessible parameters, it may assist in early risk stratification and guide clinical decision-making.</p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site