TAKADA Takuma    Department   Research Institutes and Facilities, Research Institutes and Facilities    Position   Assistant Professor
Language	English
Title	Utility and Application of Simplified PESI Score for Identification of Low-risk Patients with Pulmonary Embolism in the Era of DOAC
Conference	第87回日本循環器学会学術集会
Conference Type	Nationwide Conferences
Presentation Type	Speech
Lecture Type	General
Publisher and common publisher	Ryusuke Nishikawa, Kazuhisa Kaneda, Ryuki Chatani, Yuji Nishimoto, Nobutaka Ikeda, Yohei Kobayashi, Satoshi Ikeda, Kitae Kim, Toru Takase, Shuhei Tsuji, Maki Ohi, Takuma Takada, Kazunori Otsui, Jiro Sakamoto, Yoshito Ogihara, Yugo Yamashita
Date	2023/03/10
Venue (city and name of the country)	福岡
Summary	Background: The simplified pulmonary embolism severity index (sPESI) score could help the identification of low-risk patients with pulmonary embolism (PE) for early hospital discharge or outpatient treatment. However, the utility and application of the sPESI score has not been fully evaluated in the Era of direct oral anticoagulant (DOAC). Methods: The COMMAND VTE Registry-2 is a multicenter registry enrolling 5,197 consecutive acute symptomatic venous thromboembolism (VTE) patients among 31 centers in Japan between January 2015 and August 2020. The current study population consisted of 2,787 patients with PE, who were divided into 2 groups; sPESI scores of 0 and 1 or greater. Results: Patients with a sPESI score of 0 accounted for 609 (22%) patients, and among 531 outpatients, a majority of patients (82%) treated inpatient with a median length of hospital stay of 13 days. The cumulative 30-day incidence of all-cause death was lower in patients with a sPESI score of 0 than those with the score of 1≤ (0.0% vs. 7.1%, log rank P<0.001). There was no significant difference in the cumulative 30-day incidence of recurrent VTE between the 2 groups (0.8% vs. 0.5%, log rank P=0.40), whereas, the cumulative 30-day incidence of major bleeding was lower in patients with a sPESI score of 0 (1.8% vs. 5.3%, log rank P<0.001). Conclusions: In patients with a sPESI score of 0, there was no 30-day mortality, and risks of recurrent VTE and major bleeding were reasonably low, although a majority of patients treated inpatient with a long hospital stay in the real-world clinical practice of the DOAC Era.