The accuracy of combined use of troponin and red cell distribution width in predicting mortality of patients with acute pulmonary embolism

• Published in: Wiener Klinische Wochenschrift Vol. 128; no. Suppl 8; pp. 596 - 603
• Main Authors: Yazıcı, Selçuk, Kırış, Tuncay, Ceylan, Ufuk S., Akyüz, Şükrü, Uzun, Ahmet O., Hacı, Recep, Terzi, Sait, Doğan, Abdullah, Emre, Ayşe, Yeşilçimen, Kemal
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 01.12.2016
• Subjects: Acute Disease; Aged; Endocrinology; Erythrocyte Count - statistics & numerical data; Erythrocyte Indices; Female; Gastroenterology; Humans; Internal Medicine; Lung Diseases - blood; Lung Diseases - diagnosis; Lung Diseases - mortality; Male; Medicine; Medicine & Public Health; Original Article; Pneumology/Respiratory System; Prevalence; Prognosis; Reproducibility of Results; Risk Assessment - methods; Sensitivity and Specificity; Survival Analysis; Troponin - blood; Turkey - epidemiology; TR score; SPESI score; Acute pulmonary embolism; Red cell distribution width; Short-term mortality
• ISSN: 0043-5325; 1613-7671
• DOI: 10.1007/s00508-016-1081-y

Summary Background Cardiac troponins and red cell distribution width (RDW) are associated with increased mortality in acute pulmonary embolism (PE). In this study, we aimed to investigate the accuracy of the combined use of troponin and RDW in predicting short-term mortality in acute PE patients. Methods The data of 201 patients with the diagnosis of acute PE were retrospectively analyzed. We obtained troponin–RDW scores (TR scores) using a combination of troponin and RDW values, and then evaluated this score’s accuracy in predicting mortality in patients with acute PE. Results The mean participant age was 68 ± 16 years, and 52 % of patients were female. Fifteen (7.4 %) patients died during the first month. Patients classified as high-risk according to TR scores were older (72 ± 15 vs. 66 ± 15 years, p  = 0.005), and they had higher heart rates (101 ± 20 vs. 90 ± 15 beat/min, p  < 0.001) and respiratory rates (23 ± 4 vs. 21 ± 3 breath/min, p  = 0.001). In multivariate analysis, TR (odds ratio [OR] 4.93, 95 % confidence interval [CI] 1.13–21.38, p  = 0.033) and simplified pulmonary embolism severity index (sPESI) scores (OR 3.78, 95 % CI 1.71–8.37, p  = 0.002) were independent predictors of 30-day mortality. For 30-day mortality, the TR score had a slightly lower sensitivity (87 % vs. 93 %), but a higher specificity (69 % vs. 52 %) compared to the sPESI score. Conclusion The TR score is easy to calculate, and it may be used to predict early mortality in patients with acute PE.