{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T06:46:09Z","timestamp":1789195569896,"version":"build-2803163510"},"reference-count":38,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T00:00:00Z","timestamp":1708387200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>(1) Background: Acute pulmonary embolism (PE) is a significant public health concern that requires efficient risk estimation to optimize patient care and resource allocation. The purpose of this retrospective study was to show the correlation of NLR (neutrophil-to-lymphocyte ratio) and PESI (pulmonary embolism severity index)\/sPESI (simplified PESI) in determining the risk of in-hospital mortality in patients with pulmonary thromboembolism. (2) Methods: A total of 160 patients admitted at the County Clinical Emergency Hospital of Sibiu from 2019 to 2022 were included and their hospital records were analyzed. (3) Results: Elevated NLR values were significantly correlated with increased in-hospital mortality. Furthermore, elevated NLR was associated with PESI and sPESI scores and their categories, as well as the individual components of these parameters, namely increasing age, hypotension, hypoxemia, and altered mental status. We leveraged the advantages of machine learning algorithms to integrate elevated NLR into PE risk stratification. Utilizing two-step cluster analysis and CART (classification and regression trees), several distinct patient subgroups emerged with varying in-hospital mortality rates based on combinations of previously validated score categories or their defining elements and elevated NLR, WBC (white blood cell) count, or the presence COVID-19 infection. (4) Conclusion: The findings suggest that integrating these parameters in risk stratification can aid in improving predictive accuracy of estimating the in-hospital mortality of PE patients.<\/jats:p>","DOI":"10.3390\/jcm13051191","type":"journal-article","created":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T04:36:22Z","timestamp":1708403782000},"page":"1191","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Enhancing Pulmonary Embolism Mortality Risk Stratification Using Machine Learning: The Role of the Neutrophil-to-Lymphocyte Ratio"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1121-3788","authenticated-orcid":false,"given":"Minodora","family":"Teodoru","sequence":"first","affiliation":[{"name":"Medical Clinical Department, Faculty of Medicine, \u201cLucian Blaga\u201d University, 550024 Sibiu, Romania"},{"name":"County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihai Octavian","family":"Negrea","sequence":"additional","affiliation":[{"name":"Medical Clinical Department, Faculty of Medicine, \u201cLucian Blaga\u201d University, 550024 Sibiu, Romania"},{"name":"County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreea","family":"Cozgarea","sequence":"additional","affiliation":[{"name":"County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania"},{"name":"Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania"},{"name":"Cardiology Department, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7378-7787","authenticated-orcid":false,"given":"Drago\u0219","family":"Cozma","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania"},{"name":"Cardiology Department, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Research Center of the Institute of Cardiovascular Diseases Timi\u0219oara, 300310 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6646-1585","authenticated-orcid":false,"given":"Adrian","family":"Boicean","sequence":"additional","affiliation":[{"name":"Medical Clinical Department, Faculty of Medicine, \u201cLucian Blaga\u201d University, 550024 Sibiu, Romania"},{"name":"County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2363","DOI":"10.1161\/ATVBAHA.114.304488","article-title":"Thrombosis","volume":"34","author":"Raskob","year":"2014","journal-title":"Arterioscler. 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