Comparison of risk assessment scores in patients with pulmonary embolism

Background
Pulmonary embolism (PE) is one of the most fatal emergencies with a high risk of mortality. Multiple risk stratification scores have been developed to assess a patient’s overall mortality risk.


Objective
This study aimed to validate modified FAST and modified Bova scores for risk stratification and predicting the risk of early mortality in patients presenting with acute PE.


Patients and methods
Patients admitted to Assiut University Hospital with PE were sequentially included. Pulmonary Embolism Severity Index (PESI), modified Bova, and modified FAST scores were calculated for all included patients.


Results
A total of 100 patients with PE were sequentially included. It was found that predictors of in-hospital mortality in patients with PE were; chronic heart failure [odds ratio (OR)= 1.87], chronic respiratory disease (OR= 1.99), chronic kidney disease (OR= 2.01), hypotension (OR= 2.99), intermediate-high risk- PESI (simplified version; OR=2.76), intermediate-high risk modified Bova score (OR= 3.01) and intermediate-high risk modified FAST score (OR= 3.90).It was found that the modified FAST score had the best diagnostic accuracy (89.2%) with an area under the curve (AUC) 0.962, followed by the modified Bova score with accuracy 76.8% and AUC 0.761. The two scores had higher accuracy than that for PESI score (53.4%, AUC= 0.627).


Conclusion
Modified FAST and modified Bova scores are simple and reliable tools for risk stratification of patients with acute PE.