Sincope is a risk marker in Pulmonary Embolism (PE) with a low risk clinical profile (sPESI:0)

Abstract

Introduction: Despite the fact that the Sincope is an alarming symptom that always forces us to suspect significant cardiac dysfunction, the most recommended Clinical Scales for the prognostic evaluation of the PE do not include it as a risk parameter, for the refusal on the part of the classic studies to observe an association with the clinical outcome. Among patients who, due to their clinical profile of Low Risk, would be candidates for extrahospital management, its prognostic significance is especially necessary to clarify. Objective: Considere if the presence of Sincope is associated with mortality in a large cohort of patients with PE and a low risk clinical profile according to the sPESI scale. Material and Methods: Patients included in the RIETE Registry until March 2017 and who presented a score of 0 on the sPESI scale. The Student and Mann-Whitney tests were used to compare the continuous variables, and the Chi-square test for qualitative ones. Univariate logistic regression analyzes were performed and a predictive model was constructed using multivariate logistic regression with the selected variables. Conclusion: In patients with a low risk clinical profile according to the sPESI scale, the presence of Sincope increases significantly the probability of short-term death. When making decisions about the initial outpatient management of PE its presence should be taken into account.