Timely identification of acute pulmonary embolism (PE) in patients at high risk for death in the ICU remains a critical challenge.
In a study published in  Clinical and Applied Thrombosis/Hemostasis, researchers sought to develop a simple, biomarker-based nomogram for early identification of acute PE in patients at high risk for 28-day mortality in the ICU. Timely risk stratification is crucial for guiding interventions and improving patient outcomes.
Leveraging data from 1,083 patients with acute PE in ICUs in the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, researchers identified eight independent predictors of mortality: age  greater than 66 years, neutrophil-to-lymphocyte ratio (NLR)  greater than 10.1, lymphocyte-to-monocyte ratio (LMR) less than 1.5, red blood cell distribution width (RDW) greater than 14.35, respiratory rate (RR) greater than 26 breaths/min, oxygen saturation (SpO₂), vasopressor use, and presence of malignant cancer. These variables were incorporated into a nomogram that demonstrated excellent calibration and strong discriminative ability, with an area under the receiver operating characteristic curve of 0.772 (95% CI, 0.732-0.811; P < 0.001), outperforming existing risk scores.
By combining readily available clinical and laboratory parameters, this simple-to-use tool enables rapid identification of patients with PE at high risk for death, supporting timely clinical decisions and potentially improving ICU outcomes.