A novel predictor of short-term prognosis in acute pulmonary embolism: inflammatory burden index

Background: Inflammation significantly impacts disease progression and prognosis in acute pulmonary embolism (APE); however, the optimal method to quantify this inflammation for prognostic purposes remains unclear. Objectives: We aimed to identify the most effective blood-based inflammatory marker for predicting short-term mortality in patients with APE. Methods: We retrospectively analyzed 301 patients with APE. We compared the predictive performance of nine inflammatory markers for 30-day mortality, focusing on the inflammatory burden index (IBI), and contrasted it with the standard clinical score (sPESI). Results: After adjusting for potential confounders, a higher IBI was strongly and independently associated with an increased risk of 30-day mortality. IBI demonstrated superior predictive ability compared with all other inflammatory markers and the sPESI score. The relationship between IBI and mortality risk was linear; higher IBI values corresponded to greater mortality risk. Conclusion: IBI is a robust and independent predictor of short-term survival in patients with APE. Calculated from routine blood tests (C-reactive protein, neutrophil, and lymphocyte counts), it offers a simple, rapid, and cost-effective tool that may enhance early risk stratification and guide personalized treatment decisions in clinical practice. Further validation in independent cohorts is required to confirm its prognostic utility.