PATHOS Score as a Predictor of In-Hospital Mortality in Patients with Acute Cardiogenic Pulmonary Edema Presenting to the Emergency Department

PATHOS Score in Acute Pulmonary Edema

Abstract

Objective: The platelets, age, troponin, heart rate, oxygenation, and systolic blood pressure (PATHOS) score, was assessed in this study for its ability to predict in-hospital mortality in patients with acute cardiogenic pulmonary edema (ACPE), who were admitted to the emergency department (ED).
Methods: Between March 1, 2023, and 2025, the study was carried out retrospectively in the ED of a tertiary university hospital. Adult patients with an ACPE diagnosis who were at least 18 years old were enrolled. Admission data were used to calculate PATHOS scores and analyze outcomes between survivors and non-survivors.
Results: A total of 622 patients satisfied the inclusion requirements for this investigation. Of these, 531 patients (85.4%) survived hospitalization, while 91 (14.6%) died. In multivariate logistic regression analysis, the PATHOS score emerged as an independent predictor of in-hospital mortality, with an odds ratio of 2.27 [95% confidence interval (CI): 1.47-3.52; p<0.001]. Receiver operating characteristic analysis revealed an area under the curve of 0.814 (95% CI: 0.781-0.844), indicating strong discriminative performance. A threshold value greater than 3 for the PATHOS score yielded a sensitivity of 79.1%, specificity of 74.2%, and a negative predictive value of 95.4% for predicting in-hospital mortality.
Conclusion: The PATHOS score stands out as an effective tool for predicting in-hospital mortality risk among patients presenting to the ED with ACPE. As it can be easily calculated via routine admission data, this score may be utilized for early risk stratification in clinical practice.