Predicting Hospital Survival in Patients Admitted to ICU with Pulmonary Embolism

Figures

• 

  Figure 1.. Receiver operating characteristic curves for the APACHE-IV, PESI, sPESI, and ICU-sPESI score for predicting in-hospital mortality.

• 

  Figure 2.. (A-D) Actual versus predicted mortality across the spectrum of scores for APACHE-IV (A), PESI (B) (both scores shown in deciles), sPESI (C), and ICU-sPESI (D) (both scores shown in direct score values). Vertical dotted line indicates the score threshold for a NPV of >99% for each test for critically ill patients with PE.

• 

  Figure 3.. Kaplan–Meier survival curves following ICU admission for PESI classes (A), sPESI scores (B), and ICU-sPESI scores (C). For all scores, survival differed significantly across all groups (multivariate log-rank test; P < 0.001). Pairwise survival curve comparisons statistically significant by log-rank test (adjusted for multiple comparisons by Bonferroni correction): (A) PESI classes: PESI class V versus IV, III, II, I: P-values <0.001, <0.001, <0.001, 0.004, respectively. (B) sPESI score: sPESI score 5 versus 3, 2, 1, 0: P-values 0.015, <0.001, <0.001, <0.001, respectively. sPESI score 4 versus 3, 2, 1, 0: P-values 0.010, <0.001, <0.001, <0.001, respectively. sPESI score 3 versus 2, 1, 0: P values 0.021, <0.001, 0.010, respectively. (C) ICU-sPESI score: ICU-sPESI score ≥7 versus 5, 4, 3, 2, 1, 0: P-values 0.005, <0.001, <0.001, <0.001, <0.001, <0.001, respectively. ICU-sPESI score 6 versus 4, 3, 2, 1, 0: P-values 0.004, <0.001, <0.001, <0.001, <0.001, respectively. ICU-sPESI score 5 versus 4, 3, 2, 1, 0: P-values 0.027, <0.001, <0.001, <0.001, <0.001, respectively. ICU-sPESI score 4 versus 2, 1, 0: All P values <0.001. ICU-sPESI score 3 versus 2, 1, 0: P-values <0.001, <0.001,…

• 

  Figure 4.. Kaplan–Meier survival curves with 95% confidence intervals for the proposed four ICU-sPESI risk classes: Class I (ICU-sPESI score ≤2), Class II (3-4), Class III (5-6), and Class IV (≥7). The class groupings were based on pairwise comparisons of individual score survival curves (log-rank test) with groups created for scores whose survival curves did not differ significantly. No significant differences were found between scores 0 versus 1 (P = 0.431), 0 versus 2 (P = 0.627), 1 versus 2 (P = 0.653), 3 versus 4 (P = 0.336), and 5 versus 6 (P = 0.472). The grouping of scores ≥7 was done due to the limited patient numbers with ICU-sPESI scores of 8 (n = 1) and 9 (n = 0). A multivariate log-rank test confirmed a significant overall difference across the four risk classes (P < 0.001). Point estimates [95% CI] for all-cause in-hospital mortality in the four ICU-sPESI risk classes are provided in the figure.