Development and Evaluation of an Innovative Inflammatory Prognostic Score for Predicting Long-Term Mortality in Patients With Pulmonary Embolism

Q: What was the purpose of the study on PE outcomes?

To develop and evaluate an inflammatory prognostic score (IPS) that predicts long-term all-cause mortality in patients with acute pulmonary embolism.

Q: How was the IPS constructed in the study?

The IPS was built using LASSO Cox regression based on 15 inflammatory biomarkers and several derived inflammation indices, with the final formula using five routinely available markers.

Q: Did the IPS improve prediction beyond existing clinical factors?

Yes. Adding IPS to a baseline clinical model increased the time-dependent AUC (notably at 3 years) and enhanced risk stratification for all-cause mortality.

Sep 29, 2026

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Systemic inflammation is closely linked to adverse outcomes in acute pulmonary embolism (PE). This study developed and evaluated a novel inflammatory prognostic score (IPS) constructed from multiple inflammation-related biomarkers to predict long-term all-cause mortality. A retrospective cohort of 1642 confirmed acute PE patients was followed to January 2025. IPS derived from routine biomarkers showed independent association with mortality and improved risk stratification beyond established clinical predictors.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Background

Methods

Outcomes and follow-up

Biomarkers and score construction

Statistical analyses

Results

Conclusions

Wiley Mediators of Inflammation Volume 2025, Article ID 6325915, 13 pages [https://doi.org/10.1155/mi/6325915](https://doi.org/10.1155/mi/6325915) Research Article Development and Evaluation of an Innovative Inﬂammatory Prognostic Score for Predicting Long-Term Mortality in Patients With Pulmonary Embolism Ning Zhu , 1,2 Lei Zhang,3 Jiabao Wu, 1 Fei Ye, 1 Nanding Yu, 1 Chao Cao,2 and Limin Chen 1 1Department of Respiratory and Critical Care Medicine, Fujian Medical University Union Hospital, Fuzhou, Fujian, China 2Department of Respiratory and Critical Care Medicine, The First Afﬁliated Hospital of Ningbo University, Ningbo, China 3Department of Respiratory and Critical Care Medicine, The Afﬁliated People Hospital of Ningbo University, Ningbo, China Correspondence should be addressed to Limin Chen; [fzdrclm@outlook.com](fzdrclm@outlook.com)[ ](fzdrclm@outlook.com)Received 12 August 2025; Revised 19 October 2025; Accepted 27 November 2025 Academic Editor: Diogo Peruchetti Copyright © 2025 Ning Zhu et al. Mediators of Inﬂammation published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Background: Systemic inﬂammation is closely associated with adverse outcomes in pulmonary embolism (PE) . This study aimed to develop and evaluate a novel inﬂammatory prognostic score (IPS) derived from multiple inﬂammation-related biomarkers to predict long-term all-cause mortality in patients with acute PE. Methods: This retrospective cohort study included 1642 patients with conﬁrmed acute PE admitted between January 2016 and January 2024 at the First Afﬁliated Hospital of Ningbo University and the Afﬁliated People Hospital of Ningbo University. The primary outcome was all-cause mortality. Follow-up was conducted in January 2025 . Fifteen inﬂammatory biomarkers were analyzed, including C-reactive protein (CRP), white blood cell count (WBC), neutrophil count (NEU), lymphocyte count (LYM), monocyte count (MON), red cell distribution width (RDW), platelet count (PLT), and eight derived indices: neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), monocyte-to-lymphocyte ratio (MLR), neutrophil–MLR (NMLR), plateletto-lymphocyte ratio (PLR), systemic immune-inﬂammation index (SII), systemic inﬂammation response index (SIRI), and inﬂammatory burden index (IBI) . IPS was constructed using least absolute shrinkage and selection operator (LASSO) Cox regression. Prognostic performance was assessed using Kaplan–Meier survival analysis, multivariable Cox regression, timedependent receiver operating characteristic (ROC) analysis, and random survival forest (RSF) . Results: During a median follow-up of 43.87 months, 262 patients (16.0%) died. The IPS was calculated as: IPS = 0.395 ×IBI + 0.236 ×RDW+ 0.208 ×SIRI+ 0.115 ×MLR+ 0.040 ×CRP. Patients with high IPS (≥0.55) had a signiﬁcantly higher risk of allcause mortality compared to those with low IPS (adjusted hazard ratio [HR] = 2.55, 95% conﬁdence intervals [CI]: 1.92–3.38; p < 0:001) . Time-dependent area under the curve (AUC) for IPS were 0.756, 0.768, and 0.773 at 1, 3, and 5 years, respectively. When added to the baseline clinical model—including age, length of hospital stay, deep vein thrombosis, diastolic blood pressure, body mass index (BMI), lactate, log-transformed serum creatinine, blood urea nitrogen (BUN), log-transformed D-dimer, left ventricular ejection fraction (LVEF), pulmonary artery systolic pressure (PASP), and computed tomography pulmonary angiography (CTPA)-based embolism location (main pulmonary artery)—IPS improved the AUC from 0.820 to 0.886 at 3 years (p< 0:001, DeLong test) . RSF analysis further identiﬁed IPS as the most informative inﬂammatory predictor of mortality. Conclusions: The IPS, derived from ﬁve routinely available inﬂammatory biomarkers, was independently associated

FAQs

What was the purpose of the study on PE outcomes?

To develop and evaluate an inflammatory prognostic score (IPS) that predicts long-term all-cause mortality in patients with acute pulmonary embolism.

How was the IPS constructed in the study?

The IPS was built using LASSO Cox regression based on 15 inflammatory biomarkers and several derived inflammation indices, with the final formula using five routinely available markers.

Did the IPS improve prediction beyond existing clinical factors?

Yes. Adding IPS to a baseline clinical model increased the time-dependent AUC (notably at 3 years) and enhanced risk stratification for all-cause mortality.

Sep 29, 2026

Upload by Mafia Boss