Juan Vázquez-Epelbaum, Servicio de Cardiología, Unidad Coronaria, Sanatorio de la Trinidad Mitre; Servicio de Cardiología, Sanatorio de la Trinidad Palermo. Buenos Aires, Argentina
Ornella Robino, Servicio de Cardiología, Unidad Coronaria, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina
Agustina Piccinato, Servicio de Cardiología, Unidad Coronaria, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina
Anabel Gafni, Servicio de Cardiología, Unidad Coronaria, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina
Belén Cardone, Servicio de Cardiología, Unidad Coronaria, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina
Daniel Zanutto, Servicio de Cardiología, Unidad Coronaria, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina
Nicolás Caruso, Servicio de Cardiología, Unidad Coronaria, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina
Rafel Iamevo, Servicio de Cardiología, Unidad Coronaria, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina
Mercedes Panno, Servicio de Cardiología, Unidad Coronaria, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina
Introduction: Pulmonary embolism (PE) is a potentially life-threatening condition that requires rapid assessment and treatment. The shock index (SI) is a clinical tool used to assess the severity of hemodynamic compromise in these patients. Fibrinolysis is a mandatory treatment for some individuals, but the decision to use it can be complex. The aim of this study was to evaluate the relationship between the SI and the need for fibrinolysis in patients with PE, as well as to determine the SI cutoff point that predicts the requirement for fibrinolytic therapy. Method: This was a retrospective, cross-sectional observational study conducted at a healthcare center in Buenos Aires, Argentina, between January 2018 and December 2023. Logistic regression was performed to establish the relationship between the SI and the need for fibrinolysis, followed by a ROC curve analysis to determine the SI cutoff point that predicts the requirement for fibrinolytic therapy. Results: The study included 26 patients with a confirmed diagnosis of acute PE, of whom 44% were male, and 18% were on prior anticoagulant therapy. A trend approaching statistical significance was found between the SI and the need for fibrinolytics (p = 0.076). Additionally, a trend suggesting that the SI could predict fibrinolytic use was observed (p = 0.41; AUC = 0.68). Conclusions: In the evaluated population, a positive trend was found indicating that the SI could be a good predictor of the requirement for fibrinolytic therapy. These results should be validated with other types of studies involving a larger number of patients.
Keywords: Pulmonary embolism. Shock index. Fibrinolysis.
