Predictive Value of sPESI Combined with RDW,NLR and MLR for Early Risk in Patients with Non-high-risk Acute Pulmonary Embolism
Objective To explore the predictive value of the simplified pulmonary embolism severity index(sPESI)in conjunction with red blood cell distribution width(RDW),neutrophil to lymphocyte ratio(NLR)and monocyte to lymphocyte ratio(MLR)for the early risk assessment of patients with non-high risk acute pulmonary embolism(APE).Methods Non-high risk APE patients admitted to the Yinchuan First People's Hospital from October 2018 to October 2022 were collected.Patients were divided into event and non-event groups based on the occurrence of composite endpoint events within 30 days of onset.The study analyzed the differences in sPESI scores and various clinical indicators between the two groups to identify independent predictors for the occurrence of composite endpoint events in non-high risk APE patients within 30 days.Receiver operating characteristic(ROC)curves were drawn to evaluate the predictive value of combining sPESI with routine blood markers for early risk in non-high risk APE patients.Results This study included 187 non-high risk APE patients,with 49 in the event group and 138 in the non-event group.There were statistically significant differences between the two groups in terms of sPESI scores,RDW,NLR,MLR,platelet to lymphocyte ratio(PLR),oxygen saturation of the finger pulse(SpO2),arterial oxygen saturation(SaO2),C-reactive protein(CRP),creatinine,N-terminal pro-brain natriuretic peptide(NT-proBNP),lactic dehydrogenase(LDH),cholinesterase,triglycerides,and Na+(P all＜0.05).Binary Logistic regression analysis showed that RDW,NLR,and MLR were independent predictors of composite endpoint events within 30 days in patients with non-high risk APE(P all＜0.05).ROC curve analysis revealed that the area under the curve(AUC)for sPESI was 0.761(95%CI:0.683-0.839),while the AUC for the combination of sPESI+RDW+NLR+MLR was 0.861(95%CI:0.774-0.909).Conclusion The combination of sPESI,RDW,NLR and MLR has a high predictive value for early risk in patients with non-high risk APE,especially suitable for implementation in primary healthcare institutions.
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