The Vulnerable Elders Survey-13 (VES-13) scale is superior to sPESI in predicting 3-month post-discharge mortality in elderly survivors of acute pulmonary embolism.

INTRODUCTION: Acute pulmonary embolism (APE) is the most serious manifestation of venous thromboembolism. The Simplified Pulmonary Embolism Severity Index (sPESI) is employed for prediction of 30-day mortality in APE. The Vulnerable Elders Survey (VES-13) is used to identify participants at risk of health impairment.

OBJECTIVES: To compare the VES-13 scale and sPESI in predicting the 3-month mortality in elderly patients hospitalized for APE.

PATIENTS AND METHODS: All patients with APE were managed according to ESC guidelines and followed up for at least 3 months after discharge. In the clinical evaluation of all patients, the Charlson comorbidity index (CCI) and biochemical tests were performed. Patients with VES-13≥3 scores were evaluated with comprehensive geriatric assessment (CGA).

RESULTS: Among the total patients, 164 met the inclusion criteria. There was a significantly lower percentage of men in the VES-13≥3 vs VES-13<3 group (34% vs 54.5%, P<0.01). Patients with VES-13≥3 vs VES-13<3 points group were characterized by lower BMI (median 25.6 vs 28, P=0.001) and higher sPESI (median 2 vs 1 point, P<0.001). There were no differences in APE severity according to ESC stratification and CCI. Logistic regression analysis identified the VES-13 score as the significant independent risk factor for the 3-month mortality.

CONCLUSIONS: The VES-13 is a better tool than sPESI for predicting the 3-month mortality. Geriatric survivors of APE characterized with VES-13≥3 points should be closely monitored after discharge. The Norton scale in combination with the VES-13 may be useful in predicting 3-month mortality among the numerous tests used in the CGA.