[雙語翻譯]--醫(yī)學外文翻譯--肺栓塞嚴重程度指數(shù)預測肺栓塞患者的預后分析（英文）

1、The Pulmonary Embolism Severity Index in Predicting the Prognosis of Patients With Pulmonary Embolism Won-Ho Choi 1, Sung Uk Kwon 1,2, Yoon Jung Jwa 1, Jung A Kim 1, Yun-Ho Choi 1, Je Ho Chang 1, Hoon Jung 1, Joon Hyung

2、Doh 1,2, June Namgung 1,2, Sung Yun Lee 1,2 and Won Ro Lee 1,2Departments of 1Internal Medicine and 2VISION 21 Cardiac 24:123-127)Keywords: Pulmonary embolism; PrognosisReceived: April 13, 2008 Accepted: July 28, 2008C

3、orrespondence to Sung Uk Kwon, MD Department of internal medicine, Inje University Ilsan Paik Hospital, 2240 Daehwa-dong, Ilsan-gu, Goyang 411-706, Korea Tel: 82-31-910-7830, Fax: 82-31-910-7219, E-mail: mdksu@ilsanpai

4、k.ac.krINTRODUCTIONPulmonary embolisms occur relatively frequently, with23 cases per 100,000 annually in the United States [1].However, since its clinical features are nonspecific, adiagnosis of pulmonary embolism is not

5、 easy to make.Furthermore, without appropriate treatment, a pulmonaryembolism can be fatal. Therefore, suspecting such acondition and evaluating it appropriately is important inmaking a prognosis. Once a prognosis has be

6、en made, themortality rate can be lowered through proper treatment.However, while significant effort has been made toclarify the risk factors and treatment of pulmonaryembolism, relatively little data are available regar

7、ding aprognostic index. Nevertheless, since the developmentof the Geneva score [2] in 2000 and the PulmonaryEmbolism Severity Index (PESI) [3] in 2005, two modelshave been introduced as prognostic-predictive indexes.Of t

8、hese, the PESI has been shown to have higher predic-tive accuracy [4].Ostensibly, Koreans may appear to have fewer riskfactors for pulmonary embolism, such as obesity or deepvein thrombosis, compared to people in the Wes

9、t, andmay thus be expected to suffer from pulmonary embolisms(13.3%) had diabetes, and 16 (17.8%) had either beendiagnosed with cancer or were being treated for cancer.Nine patients (10%) were confirmed as having emphyse

10、mathrough chest CT, while ten patients (11.1%) had a cerebralhemorrhage and cerebral infarction, and 26 (28.9%) had asurgical history (Table 1). PESI ClassificatichWith regard to the distribution of the patients accordin

11、gto their PESI risk class, 21 (23%, 34-65 points, average:49.9 points) patients were in class I (126 PESI points);thus, most of the patients were in class II while the smallestnumber were in class IV (Fig. 1).Mortality r

12、ate base on the PESIThe mortality rate after 30 days, mortality rate duringhospitalization, and total mortality rate were comparedaccording to the PESI risk classes of the patients. At 30days, the mortality rate was 11.1

13、%. When this result wasanalyzed according to PESI class, a significant trendtoward increased mortality with a higher class wasdetected (p=0.0016), with 0% in class I, 10.3% in class II,9.1% in class III, 0% in class IV,

14、and 50% in class V. Inconsidering the 0% mortality rate detected for class IV,note that the average hospital stay for this group was 10days shorter than that for the other groups; thus, thepossibility of underestimation

15、exists. In comparison, thehospital mortality rate was 15.6%; when it was analyzedaccording to PESI class, a significant trend (p=0.0065)was observed, with 4.8% in class I, 13.8% in class II, 13.6%in class III, 12.5% in c

16、lass IV, and 50% in class V (Fig. 2).The total mortality rate was 30%; when it was analyzedaccording to PESI class, an increasing tendency towardthe higher class was observed, with 9.5% in class I, 27.6%in class II, 31.8

17、% in class III, 50% in class IV, and 60% inclass V (p=0.0019) (Fig. 3). Mortality rate of the redistri-buted PESIGrouping of the PESI classes into low- (class I),intermediate- (classes II-IV), and high-risk (class V)grou

18、ps produced a 30-day mortality rate of 0, 8.2, and50%, respectively. Compared to the results before theredistribution, the tendency was quite clear (p=0.0016→0.0003). The mortality rate during hospitalization was4.8, 13.

19、1, and 50% for the low-, intermediate-, and high-risk groups, respectively, and the tendency was muchclearer (p=0.0065→0.0038), as was the 30-day mortalityrate. The total mortality rate was 9.5, 31.1, and 60% for thelow-

20、, intermediate-, and high-risk groups, respectively,Choi WH, et al. Use of PESI to predict prognosis of pulmonary embolism 125Figure 1. Patients distribution according to PESI risk class.23% (n=21)32% (n=29)25% (n=22)

21、9% (n=8)11% (n=10)class I class II class III class IV class VFigure 2. Hospital mortality according to PESI risk classification. PESI, pulmonary embolism severity index; NS, not significant.50.00%40.00%30.00%20.00%10.00%

22、0.00% Class I Class II Class III Class IV Class VHospital Mortalityp=0.026p=NS4.80%13.80% 13.60% 12.50%50%Figure 3. Overall mortality according to PESI risk classification. PESI, pulmonary embolism severity index; NS, no