PEACE Score Accurately Predicts Echo Abnormalities in Pulmonary Embolism Patients: Study Shows
Türkiye: A recent study published in BMC Emergency Medicine has validated the Pulmonary Embolism Advanced Cardiac Evaluation (PEACE) Score as a reliable tool for identifying echocardiographic abnormalities in patients diagnosed with pulmonary embolism (PE). The study, conducted by Dr. Kazım Ersin Altınsoy at Gaziantep City Hospital and Gaziantep Islam Science and Technology University, Türkiye, supports the use of the PEACE Score for early risk stratification in emergency settings.
According to the study, the PEACE Score accurately stratifies pulmonary embolism risk, with strong links to echo abnormalities (AUC 0.82) and RV dysfunction (AUC 0.85). A score >5 offers 84.6% sensitivity and 79.2% specificity, aiding swift ICU triage in high-risk cases.
Pulmonary embolism is a potentially fatal condition that demands swift clinical assessment. The PEACE Score was developed as a comprehensive risk tool that combines clinical data, lab values, and cardiac parameters to guide management decisions. This prospective study aimed to evaluate how effectively the PEACE Score correlates with echocardiographic findings, especially right ventricular dysfunction, and whether it could serve as a reliable predictor of patient outcomes.
The study enrolled 120 adult patients diagnosed with PE via CT angiography in the emergency department. Based on PEACE Scores, patients were classified into three categories: low risk (<3 points), intermediate risk (3–5 points), and high risk (>5 points). Echocardiographic data were collected but not used for categorization—rather, they were evaluated separately to assess the score’s predictive validity.
The following were the key findings of the study:
- PEACE Scores showed a strong positive correlation with abnormal echocardiographic findings (r = 0.685).
- The score achieved an AUC of 0.82 for predicting overall echocardiographic abnormalities.
- It recorded an AUC of 0.85 for detecting right ventricular dysfunction.
- A PEACE Score cutoff >5 demonstrated 84.6% sensitivity and 79.2% specificity in identifying significant echocardiographic changes.
- Higher PEACE Scores were significantly associated with elevated CRP levels (r = 0.524).
- One-year survival rates were 85% in the low-risk group, 65% in the intermediate-risk group, and 45% in the high-risk group.
- Kaplan-Meier analysis showed statistically significant differences in survival across the three risk categories.
Dr. Ersin Altınsoy concluded that the PEACE Score offers a rapid, accessible, and effective method for assessing PE severity and guiding early treatment decisions. Notably, patients in the high-risk category were more likely to require thrombolytic therapy and intensive care support, indicating the score's potential role in triage and resource planning.
While promising, the author notes that the PEACE Score is not intended to predict long-term survival or evaluate comorbid conditions, and larger studies are warranted to confirm its broader applicability. Still, integrating the PEACE Score into emergency protocols could significantly enhance early diagnostic accuracy and treatment pathways for pulmonary embolism.
Reference:
Altınsoy, K.E. Validation of the PEACE score for predicting abnormal echocardiographic findings in pulmonary embolism patients. BMC Emerg Med 25, 96 (2025). https://doi.org/10.1186/s12873-025-01259-z
