A functionalized method for assessing the risk of adverse events in patients with pulmonary embolism - Research focus

Sep 28, 2026

Pulmonary embolism (PE) is a common, potentially fatal emergency condition where accurate early risk stratification is essential. Existing prognostic tools such as PESI and PERFORM use discrete scoring systems and include subjective variables that can bias prediction. This study introduces CON-PERFORM, a functional prognostic model using objective parameters (age, heart rate, and PaO2) with continuous optimization-derived weights, evaluated in retrospective and prospective cohorts and shown to outperform PERFORM in AUC, accuracy, and specificity.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Introduction

Methods

Results

Conclusion

TYPE Original Research PUBLISHED 19 December 2025 DOI 10. 3389/fmed.2025.1701432 OPEN ACCESS EDITED BY Manan Pareek, University of Copenhagen, Denmark REVIEWED BY Sai Gautham Kanagala, Metropolitan Hospital Center, United States Filipa Gerardo, Hospital Prof. Doutor Fernando Fonseca, EPE, Portugal *CORRESPONDENCE Long Yu [20110290015@fudan.edu.cn](20110290015@fudan.edu.cn)[ ](20110290015@fudan.edu.cn)Shengzhang Wang [szwang@fudan.edu.cn](szwang@fudan.edu.cn) RECEIVED 08 September 2025 ACCEPTED 03 December 2025 PUBLISHED 19 December 2025 CITATION Sun K, Yu L, Xie Z, Lu H and Wang S (2025) A functionalized method for assessing the risk of adverse events in patients with pulmonary embolism. Front. Med. 12:1701432 . doi: 10.3389/fmed.2025.1701432 COPYRIGHT © 2025 Sun, Yu, Xie, Lu and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. A functionalized method for assessing the risk of adverse events in patients with pulmonary embolism Keyu Sun1,2 , Long Yu1,3,4* , Zichen Xie2 , Haisu Lu2 and Shengzhang Wang1* 1 Institute of Biomechanics, College of Biomedical Engineering, Fudan University, Shanghai, China, 2 Emergency Department, Minhang Hospital, Fudan University, Shanghai, China, 3Transvascular Implantation Devices Research Institute, Hangzhou, China, 4 School of Public Health, Zhejiang University, Hangzhou, China Background: Pulmonary embolism (PE) is a common and potentially fatal condition in emergency medicine, and accurate early risk stratiﬁcation is critical for guiding clinical management. Existing prognostic models, such as the Pulmonary Embolism Severity Index (PESI) and PERFORM, rely on discrete scoring systems and subjective variables, which may introduce bias and limit predictive precision. Methods: In this study, we propose CON-PERFORM, a novel functional prognostic model that incorporates three readily available objective parameters: age, heart rate, and arterial partial pressure of oxygen (PaO2 ) . Weighting coefficients were determined through functional optimization rather than empirical cutoffs, yielding a continuous risk score designed to improve accuracy and threshold stability. A retrospective cohort of 559 objectively conﬁrmed PE patients (373 in the training set, 186 in the validation set) was used to construct and evaluate the model, and an independent prospective cohort of 128 patients was collected for further validation. Results: Compared with the PERFORM method, CON-PERFORM demonstrated superior diagnostic performance, with higher area under the curve (AUC), accuracy, and speciﬁcity, while maintaining comparable sensitivity. In the training cohort, CON-PERFORM achieved an AUC of 0.841 versus 0.793 for PERFORM, with consistent improvements observed in both the validation and prospective cohorts. Moreover, CON-PERFORM effectively stratiﬁed patients into high-and low-risk groups, which displayed distinct survival and discharge patterns over 30 days. Conclusion: In conclusion, CON-PERFORM provides a simple, objective, and robust tool for individualized risk assessment in PE. Its improved diagnostic performance and stability across cohorts highlight its potential for clinical application and resource optimization in emergency care. KEYWORDS function analysis, physiological parameters, pulmonary embolism, risk assessment, weight coefficient 1 Introduction Pulmonary embolism (PE) is a common condition in emergency departmentsand is associated with high rates of mortality and morbidity, necessitating timely and accurate treatment. Fatal outcomes typ

FAQs

What problem does the study address in pulmonary embolism risk prediction?

The study targets the need for more accurate early risk stratification in PE. It highlights limitations of existing models that rely on discrete scoring and potentially subjective variables.

How does CON-PERFORM estimate risk?

CON-PERFORM is a functional prognostic model that uses three objective parameters: age, heart rate, and arterial partial pressure of oxygen (PaO2). Weighting coefficients are determined via functional optimization, producing a continuous risk score.

What were the key performance results compared with PERFORM?

CON-PERFORM showed superior diagnostic performance versus PERFORM, including higher AUC, accuracy, and specificity while maintaining comparable sensitivity. It also stratified patients into high- and low-risk groups with distinct outcomes over 30 days.

Sep 28, 2026

Uploaded by Lucas Martin