EXTERNAL VALIDATION OF PROGNOSTIC RULES FOR 30-DAY POST-PULMONARY EMBOLISM MORTALITY: ASSESSMENT OF A CLAIMS-BASED AND THREE CLINICAL-BASED APPROACHES

IMPACT PESI sPESI Hestia Low Risk Mortalityn/N (%) 1/165 (0.6%) 3/218 (1.4%) 1/177 (0.6%) 0/160 (0%) High Risk Mortalityn/N (%) 32/408 (7.8%) 30/355 (8.5%) 32/396 (8.1%) 33/413 (8.0%) Sensitivity (95%CI) 97.0% (82.5-99.8%) 90.9% (74.5-97.6%) 97.0% (82.5-99.8%) 100% (87.0-100%) Specificity (95%CI) 30.4% (26.6-34.5%) 39.8% (35.7-44.1%) 32.6% (28.7-36.8%) 29.6% (25.8-33.7%) NPV (95%CI) 99.4% (96.2-100%) 98.6% (95.7-99.6%) 99.4% (96.4-100%) 100% (97.1-100%) PPV (95%CI) 7.8% (5.5-11.0%) 8.5% (5.9-12.0%) 8.1% (5.7-11.3%) 8.0% (5.6-11.1%) C-index (95%CI) 0.80 (0.75-0.86) 0.81 (0.73-0.88) 0.73 (0.65-0.81) 0.79 (0.72-0.86) Table 1 Prognostic Test Characteristics for 30-Day All-Cause Mortality CI=confidence interval; IMPACT= In-hospital Mortality for Pulmonary embolism using Claims daTa; NPV=negative predictive value; PESI=Pulmonary Embolism Severity Index; PPV=positive predictive value; sPESI=simplified Pulmonary Embolism Severity Index