Predictive role of the modified Glasgow prognostic score for in-hospital mortality in stable acute pulmonary embolism

Background and importance: The modified Glasgow prognostic score (mGPS) has been reported to have a prognostic value in various patient populations. However, the prognostic significance of mGPS has not been studied inacute pulmonary embolism (APE).

Objective: This study aimed to investigate the predictive value of mGPS on in-hospital mortality in patients with hemodynamically stableAPE.

Methods: We retrospectively included 258 hemodynamically stableAPE patients. Clinical, echocardiographic, and laboratory data recorded on admission. The mGPS scored as 0, 1, or 2 based on the C-reactive protein (CRP) and albumin levels.

Results: A total of 258hemodynamically stableAPE patients were included, and 28 (10.9%) died during the hospital stay. Compared with survivors, non-survivors were older, had higher N-terminal pro-B-type natriuretic peptide, CRP, creatinine, high-sensitive cardiac troponin T (hs-cTnT), and mGPS levels, and had higher pulmonary embolism severity index (PESI) at study entry. In the multivariate logistic regression analysis, NT-proBNP>2350pg/mL (OR: 2.180, 95% CI 1.102-5.213, p<0.001), hs-cTnT>21pg/mL (OR: 1.426, 95% CI 1.151-3.751, p=0.001), CRP>3.1mg/dL (OR: 1.567, 95% CI 1.072-4.429, p=0.001), PESI>139 (OR: 2.745, 95% CI 1.869-6.369, p=0.001), systolic blood pressure<100mmHg (OR: 3.465, 95% CI 1.867-8.934, p<0.001), mGPS=1 (OR: 2.120, 95% CI 1.089-3.754, p=0.011), and mGPS=2 (OR: 3.350, 95% CI 1.457-5.367, p<0.001) were independently associated with in-hospital mortality.

Conclusion: This study demonstrates the mGPS, which is a new and easily measurable marker, is a useful predictor in-hospital mortality in hemodynamically stableAPE.