Abstract
OBJECTIVES: The endothelial activation and stress index (EASIX) has gained growing recognition as a potential marker for evaluating endothelial dysfunction and survival outcomes across diverse clinical conditions. This research aimed to assess the utility of the EASIX score in predicting disease severity and prognosis in patients diagnosed with acute pulmonary embolism (APE). METHODS: A retrospective analysis was carried out on 364 consecutive patients diagnosed with APE at our hospital between 2022 and 2025. The cohort included 193 female (53%), with an average age of 64.8 ± 15.8 years. Based on clinical severity, patients were stratified into three categories: low-risk, intermediate-risk, and high-risk APE. Calculation of the EASIX score was performed using the following formula: lactate dehydrogenase (U/L) × serum creatinine (mg/dL)/platelet count (109/L). RESULTS: Higher EASIX scores independently predicted both the high-risk APE and in-hospital mortality. Additionally, the EASIX score showed positive correlations with the simplified Pulmonary Embolism Severity Index (sPESI), troponin, and N-terminal pro-brain natriuretic peptide. Receiver operating characteristic (ROC) curve analysis identified an optimal EASIX cutoff value of 1.18 for predicting high-risk APE, offering a sensitivity of 77.5% and a specificity of 72.1%, with an area under the curve (AUC) of 0.816. Comparative ROC curve analysis revealed that the EASIX score (AUC = 0.835) exhibited a higher discriminative ability for in-hospital mortality compared to both the sPESI (AUC = 0.710) and Wells (AUC = 0.592) scores. CONCLUSION: The EASIX score appears to be a reliable and easily obtainable marker for assessing both disease severity and prognosis in APE.