SHOULD LACTATE BE INCLUDED IN ASSESSING RISK FOR ACUTE PE? A SINGLE-CENTER RETROSPECTIVE ANALYSIS

ABSTRACT

SESSION TITLE Late Breaking Pulmonary Vascular Disease Posters SESSION TYPE Original Investigation Posters PRESENTED ON 10/18/2022 0130 pm - 0230 pm PURPOSE: Pulmonary embolism (PE) is a common form of thromboembolism which has a variable and non-specific presentation that can often be fatal. The Simplified Pulmonary Embolism Severity Index (sPESI) which includes hemodynamic parameters of perfusion has been shown to correlate with 30-day mortality in patients with acute PE. The purpose of this quality improvement project was to compare how lactate and sPESI perform in predicting clinical outcomes at our institution with the hopes of developing institutional guidelines for management of patients admitted with an acute PE. METHODS: We conducted a single center retrospective analysis on patients admitted to the intensive care unit with a new diagnosis of PE between the years 2016-2021. Patients were identified using ICD-9 CM codes. Exclusion criteria included current or prior positive testing for SARS-CoV-2 (COVID-19). We performed univariate, multivariate, and ROC (Receiver Operating Characteristic) analysis to assess correlations between all cause mortality, lactate, and sPESI. Both lactate and sPESI were included as continuous variables. Our covariates included age, sex, Body Mass Index, prior or current history emphysema/COPD, smoking, CKD, diabetes, cancer, atrial fibrillation, and CHF. All analysis was carried out using software R version 3.6.3. RESULTS: Of the 161 patients who were included in the study, the mean age was 60 years (SD 17 years) and 38% (61/161) were females. 31 patients (19.3%) were deceased. Mean BMI of study participants was 29.9 kg/m2. Comorbidities included 9.9% (16/161) with emphysema/COPD, 44% (71/161) with active or prior history of smoking, 6% (10/161) with CKD, 12% (20/161) with diabetes, 15% (24/161) with diagnosis of cancer, 15% (24/161) with atrial fibrillation, 15% (24/161) with history of CHF. We found that in univariate analysis, both sPESI (p=3.4*10