The Prognostic Model Of 12-Month Mortality in Patients Discharged from The Hospital After Pulmonary Embolism
https://doi.org/10.20514/2226-6704-2026-16-3-204-213
EDN: JORIAV
Abstract
Objective. To identify clinical, laboratory and instrumental predictors of 12-month mortality in patients after PE and to develop a prognostic model. Material and methods. This retrospective study included 150 patients discharged after an episode of PE (2021–2024). The diagnosis was confirmed predominantly by CT pulmonary angiography. Demographic, clinical, laboratory and echocardiographic parameters were assessed. The primary endpoint was death within 12 months after PE (excluding in-hospital and early mortality within 30 days). Univariable and multivariable logistic regression were used to identify independent predictors. Model discrimination was evaluated using the AUC, and calibration using the Hosmer–Lemeshow test and a calibration plot; internal validation was performed by bootstrap resampling. Results. During follow-up, 20 patients (13.3 %) died. Three independent predictors of 12-month mortality were included in the multivariable model: hemoglobin level, estimated glomerular filtration rate (eGFR) and left ventricular ejection fraction (LVEF). The model demonstrated high discriminatory ability (AUC 0.906; 95 % CI 0.852–0.960; p <0.001) and good calibration (χ²=4.009; p=0.856). At the probability threshold p=0.08, sensitivity of the model was 100 % and specificity 69.2 %. The Mezo score showed higher AUC values compared with sPESI, ICOPER, GPS and the Yamaki scores. Conclusion. The Mezo score, based on hemoglobin level, eGFR and LVEF, provides high accuracy in predicting 12-month mortality in patients after PE and, after external validation, may be used for early risk stratification.
About the Authors
H. K. D. Musa
Department of Hospital Therapy with courses of endocrinology, hematology and clinical laboratory diagnostic Peoples’ Friendship University of Russia named after Patrice Lumumba, Ministry of Science and Higher Education of the Russian Federation; Voskresensk Hospital, Ministry of Health of the Moscow Region
Russian Federation
Competing Interests:
Russian Federation
Hamza K.D. Musa — PhD student
Moscow
Voskresensk
Competing Interests:
The authors declare that this work, its topic, subject matter, and content do not affect any competing interests.
G. A. Selivanov
Department of Hospital Therapy with courses of endocrinology, hematology and clinical laboratory diagnostic Peoples’ Friendship University of Russia named after Patrice Lumumba, Ministry of Science and Higher Education of the Russian Federation
Russian Federation
Competing Interests:
Russian Federation
Gleb A. Selivanov — 5th year Student of the Medical Institute
Moscow
Competing Interests:
The authors declare that this work, its topic, subject matter, and content do not affect any competing interests.
E. A. Iftode
Kolomna Hospital, Ministry of Health of the Moscow Region
Russian Federation
Competing Interests:
Russian Federation
Ekaterina A. Iftode — General practitioner, Outpatient Clinic No. 2
Kolomna
Kolomna, Moscow Region
Competing Interests:
The authors declare that this work, its topic, subject matter, and content do not affect any competing interests.
V. A. Kokorin
Department of Hospital Therapy with courses of endocrinology, hematology and clinical laboratory diagnostic Peoples’ Friendship University of Russia named after Patrice Lumumba, Ministry of Science and Higher Education of the Russian Federation; Department of Hospital Therapy named after academician P.E. Lukomsky of Clinical Medicine Institute, Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation (Pirogov University)
Russian Federation
Competing Interests:
Russian Federation
Valentin A. Kokorin — MD, PhD, Associate Professor, Head of the Department of Hospital Therapy with courses in Endocrinology, Hematology and Clinical and Laboratory Diagnostics, Medical Institute, RUDN University n. a. P. Lumumba of the MSHE of Russia, Moscow; Professor, Department of Hospital Therapy n. a. Academician P.E. Lukomsky, Institute of Clinical Medicine, N.I. Pirogov RNRMU of the MOH of Russia (Pirogov University)
Moscow
Competing Interests:
The authors declare that this work, its topic, subject matter, and content do not affect any competing interests.
References
1. Glazier CR, Baciewicz FA Jr. Epidemiology, etiology, and pathophysiology of pulmonary embolism. Int J Angiol. 2024;33(2):76-81. doi: 10.1055/s-0044-1785487. PMID: 38846994.
2. Mazzolai L, Aboyans V, Ageno W et al. Diagnosis and management of acute deep vein thrombosis: a joint consensus document from the European Society of Cardiology working groups of aorta and peripheral vascular diseases and pulmonary circulation and right ventricular function. Eur Heart J. 2018;39(47):4208-4218. doi: 10.1093/eurheartj/ehx003. PMID: 28329262.
3. Raskob GE, Angchaisuksiri P, Blanco AN et al.; ISTH Steering Committee for World Thrombosis Day. Thrombosis: a major contributor to global disease burden. Arterioscler Thromb Vasc Biol. 2014;34(11):2363-71. doi: 10.1161/ATVBAHA.114.304488. PMID: 25304324.
4. Konstantinides SV, Barco S, Lankeit M et al. Management of Pulmonary Embolism: An Update. J Am Coll Cardiol. 2016;67(8):976-990. doi: 10.1016/j.jacc.2015.11.061. PMID: 26916489.
5. Ng AC, Chung T, Yong AS et al. Long-term cardiovascular and noncardiovascular mortality of 1023 patients with confirmed acute pulmonary embolism. Circ Cardiovasc Qual Outcomes. 2011;4(1 ):122-8. doi: 10.1161/CIRCOUTCOMES.110.958397. PMID: 21098781.
6. Cannon JE, Su L, Kiely DG et al. Dynamic Risk Stratification of Patient Long-Term Outcome After Pulmonary Endarterectomy: Results From the United Kingdom National Cohort. Circulation. 2016;133(18):1761- 71. doi: 10.1161/CIRCULATIONAHA.115.019470. PMID: 27052413.
7. Valerio L, Grochtdreis T, Mavromanoli AC et al. Burden and long-term impact of pulmonary embolism on health-related quality of life: a matched cohort study. Eur J Prev Cardiol. 2025;32(15):1506-1514. doi: 10.1093/eurjpc/zwaf307. PMID: 40367140.
8. Lamba M, Pickering JW, Than M et al. Long-term outcomes in patients w ith pulmonary embolism: results from a longitudinal cohort study. Intern Med J. 2021;51(5):699-704. doi: 10.1111/imj.14409 . PMID: 31211888.
9. Elias A, Mallett S, Daoud-Elias M, et al. Prognostic models in acute pulmonary embolis m: a systematic review and meta-analysis. BMJ Open. 2016;6(4):e010324. doi: 10.1136/bmjopen-2015-010324. PMID: 27130162.
10. Zhou XY, Ben SQ, Chen HL et al. The prognostic value of pulmonary embolism severity index in acute pulmonary embolism: a metaanalysis. Respir Res. 2012;13(1):111. doi: 10.1186/1465-9921-13-111. PMID: 23210843.
11. Dentali F, Riva N, Turato S et al. Pulmonary embolism severity index accurately predicts long-term mortality rate in patients hospitalized for acute pulmonary embolism. J Thromb Haemost. 2013;11(12):2103-10. doi: 10.1111/jth.12420. PMID: 24119089.
12. Goldhaber SZ, Visani L, De Rosa M. Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet. 1999;353(9162):1386-9. doi: 10.1016/s0140-6736(98)07534-5. PMID: 10227218.
13. Wicki J, Perrier A, Perneger TV et al. Predicting adverse outcome in patients with acute pulmonary embolism: a risk score. Thromb Haemost. 2000;84(4):548-52. doi: 10.1055/s-0037-1614065. PMID: 11057848.
14. Yamaki T, Nozaki M, Sakurai H et al. Presence of lower limb deep vein thrombosis and prognosis in patients with symptomatic pulmonary embolism: preliminary report. Eur J VascEndovasc Surg. 2009;37(2):225-31. doi: 10.1016/j.ejvs.2008.08.018. PMID: 18922710.
15. Konstantinides SV, Meyer G, Becattini C et al.; ESC Scientific Document Group. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020;41(4):543-603. doi: 10.1093/eurheartj/ehz405. PMID: 3150442.
16. Slabbynck H, Clukers J, Galdermans D. Should oral anticoagulation be discontinued after 3 months in the setting of a first high-risk pulmonary embolism secondary to a major transient/reversible risk factor? Eur Respir J. 2020;55(1):1902028. doi: 10.1183/13993003.02028-2019. PMID: 32001499.
17. Højen AA, Nielsen PB, Overvad TF et al. Long-Term Management of Pulmonary Embolism: A Review of Consequences, Treatment, and Rehabilitation. J Clin Med. 2022;11(19):5970. doi: 10.3390/jcm11195970. PMID: 36233833.
Review
For citations:
Musa H.K., Selivanov G.A., Iftode E.A., Kokorin V.A. The Prognostic Model Of 12-Month Mortality in Patients Discharged from The Hospital After Pulmonary Embolism. The Russian Archives of Internal Medicine. 2026;16(3):204-213. (In Russ.) https://doi.org/10.20514/2226-6704-2026-16-3-204-213. EDN: JORIAV
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