Prognostic Impact of Albumin/Globulin and Lactate/Globulin Ratios Combined With sPESI and BOVA Scores in Pulmonary Embolism Mortality

Objective: Pulmonary embolism (PE) is a severe form of venous thromboembolism that poses a significant risk of morbidity and mortality by leading to acute respiratory and circulatory failure. Clinical scoring systems such as the simplified pulmonary embolism severity index (sPESI) and BOVA are widely used for prognostic prediction; however, their limitations highlight the need for novel biochemical markers. This study aims to evaluate the prognostic value of albumin/globulin (A/G) and lactate/globulin (L/G) ratios in predicting in‐hospital mortality and to investigate their relationship with existing scoring systems. Methods: In this retrospective study, 151 patients diagnosed with PE between January 2018 and December 2023 was analyzed. Data on demographics, comorbidities, vital signs, laboratory values, and outcomes were collected. Prognostic performance of A/G and L/G ratios was assessed through logistic regression and receiver operating characteristic (ROC) curve analysis. Results: The mean age was 60.5 ± 20.0 years, with 53.6% female patients. Deceased patients showed significantly higher age, hemodynamic instability, and altered mental status ( p < 0.05). Among scoring systems, the PESI score exhibited the highest prognostic accuracy (AUC = 0.910), followed by sPESI (AUC = 0.856) and BOVA (AUC = 0.845). Lower A/G ratios and higher L/G ratios were significantly associated with mortality ( p < 0.05). Conclusions: This study demonstrated that A/G and L/G ratios, along with sPESI and BOVA scores, are effective in predicting in‐hospital mortality in patients with pulmonary thromboembolism (PTE). A lower A/G ratio and a higher L/G ratio were associated with poor prognosis. Furthermore, the critical role of sPESI and BOVA scores in risk stratification was confirmed.