Assessment of the modified glasgow prognostic scale and inflammatory parameters as a new prognostic indicator in pulmonary thromboembolism patients

ABSTRACT Introduction and Objective: Since Acute Pulmonary Embolism (PE) is a common and life-threatening disease, early prognostic evaluation is important. Various prognostic scoring systems have been developed for this purpose. Although most of the existing scoring systems are complicated, almost none of them have parameters evaluating the inflammatory aspect of the disease. Therefore, in our study, we aimed to evaluate other inflammatory parameters, especially the mGPS scoring system, and the effectiveness of these parameters in order to emphasize the inflammatory aspect of the disease. Material and Method: In our study, 436 patients who were hospitalized in Dicle University Faculty of Medicine, Department of Chest Diseases and Intensive Care Unit between 01.01.2020-01.01.2024 and diagnosed with acute PE were analyzed. Patients with missing vital signs, laboratory tests or other missing information in the patient records were not included. We calculated the mGPS scores of the patients and grouped them as 0, 1 and 2. We analyzed the mGPS score and other inflammatory parameters. We examined the relationship between mGPS score and PESI, 30-day and 90-day mortality rates. Results: In our study, 334 patients met the inclusion criteria. The mean age of our patients was 61.52±17.12 years. Of the 334 patients, 53.6% were female (n=179) and 155 were male (46.4%). PESI score was statistically significantly higher in patients with mGPS score 2 (p<0.001). We also found that 30- and 90-day mortality was higher in patients with mGPS score 2 (p<0.001). We found a strong, positive and significant correlation between mGPS score and PESI score (r:0.536; p<0.001). In the ROC analysis performed to predict the PESI score as low and high, the best performing parameters were albumin level (0.878) and oxygen saturation (AUC: 0.854). In terms of predictive power for mortality, our model with mGPS, oxygen saturation and systolic blood pressure performed better than sPESI (AUC:0.748; cut- off: 2.5). Conclusion: In the study, mGPS score was shown to be significant in predicting 30- day and 90-day mortality; and it performed better than sPESI in predicting PESI score. In addition, the model we created by using mGPS score, which is an inflammatory marker, oxygen saturation and systolic blood pressure together can be used to predict prognosis because it is less complicated and performs better than sPESI.