Venous thromboembolism (VTE) is a common pathology. The clinical presentation of pulmonary embolism (PE) is sometimes poor and requires the use of stratification scores for mortality risk. The s-PESI score has excellent sensitivity and a strong negative predictive value of the 30-day mortality. The main objective of our study was to evaluate the mortality at 6 months and 1 year of pulmonary embolism based on S-PESI score calculated at the emergency department during diagnosis.

We performed a retrospective, single-center study of patients admitted to our university hospital emergency department for PE. The s-PESI score was calculated at admission during PE diagnosis.

Of the 379 patients included, 261 (68%) were classified s-PESI≥1 and 118 (32%) s-PESI=0. The s-PESI=0 group compared to s-PESI≥1 was younger [56.8 years±15.6 vs. 76.5 years±14.4; (P<0.001)] and had a shorter hospital stay [8.7 vs. 13.2 days; (P=0.0001)]. In the group s-PESI≥1, 38 deaths were recorded in 12 months, representing an overall survival of 82.5% at 1 year against no death in the group s-PESI=0. Regarding the criteria of the s-PESI score, the oxygen saturation<90% significantly increased the mortality (P<0.03) in univariate analysis. In addition, the NT-proBNP increase and the troponin increase were significantly associated with an increase in mortality (P<0.05 and P<0.009, respectively). Multivariate analysis showed that a patient with a history of cancer was nine times more likely to die (HR 9.6, 95% CI=[3.98, 23.11], P<0.001) with overall survival at 6 months of 75% (95% CI=[0.64, 0.84;] P<0.05).

Our retrospective study has shown that the s-PESI score items most predictive for mortality appear to be the presence of cancer at diagnosis and presentation with an oxygen saturation of less than 90% at admission. The use of a composite criterion with troponin and BNP include may be of interest in long-term stratification.