Acute pulmonary embolism (APE) is a thromboembolism situation that can be central or peripheral. APE risk analysis and classification are essential for therapy planning. Our aim is to determine the novel MAPH score (including age, mean platelet volume (MPV), total protein, and hematocrit parameters) that can distinguish APE subtypes. Our retrospective cohort analysis includes 97 APE patients referred to the emergency medicine department who underwent pulmonary computed tomography angiography (CTA) in 24 h from 2020 to 2022. The hospital information system provided demographic, clinical, laboratory, and pulmonary CTA data. APE was classified into central (46 patients) and peripheral (51 patients) depending on the area of vascular involvement. The central APE group had higher hypertension (HT) (67.4%) and atrial fibrillation (AF) (39.1%) incidence than the peripheral APE group (all p values > 0.05). The central APE had higher total protein and platelet counts (p = 0.003 and p = 0.036), but peripheral APE had higher troponin values (p = 0.029). Central APE had 2.17 ± 0.85 MAPH and peripheral APE 1.76 ± 0.95 (p = 0.029). HT, AF, platelet count, and MAPH score differed significantly in univariate logistic regression (all p values < 0.05). However, only platelet count varied in multivariate logistic regression (p = 0.042). ROC curve analysis revealed that the MAPH score predicts central APE with 83% sensitivity and 45% specificity at a cut-off level of 1.5. The new MAPH score as an indicator of blood viscosity may distinguish between central and peripheral APE. Our result is significant, especially for centers with limited examinations, as it may accelerate the diagnosis and treatment processes. We think that our results might guide future investigations.

急性肺栓塞（APE）是一种中枢性或外周性血栓栓塞情况。APE 风险分析和分类对于治疗计划至关重要。我们的目的是确定可以区分 APE 亚型的新 MAPH 评分（包括年龄、平均血小板体积 (MPV)、总蛋白和血细胞比容参数）。我们的回顾性队列分析包括 2020 年至 2022 年 24 小时内转诊至急诊科的 97 名 APE 患者，他们接受了肺计算机断层扫描血管造影 (CTA)。医院信息系统提供了人口统计、临床、实验室和肺部 CTA 数据。根据血管受累部位，APE分为中枢性（46例）和外周性（51例）。中枢性 APE 组的高血压 (HT) (67.4%) 和心房颤动 (AF) (39.1%) 发生率高于周围性 APE 组（所有 p 值 > 0.05）。中枢性 APE 具有较高的总蛋白和血小板计数（p = 0.003 和 p = 0.036），但外周 APE 具有较高的肌钙蛋白值（p = 0.029）。中枢 APE 为 2.17 ± 0.85 MAPH，外周 APE 为 1.76 ± 0.95 (p = 0.029)。HT、AF、血小板计数和 MAPH 评分在单变量 Logistic 回归中存在显着差异（所有 p 值 < 0.05）。然而，在多变量逻辑回归中，只有血小板计数发生变化（p = 0.042）。ROC 曲线分析显示，MAPH 评分以 1.5 的截止水平预测中枢 APE，敏感性为 83%，特异性为 45%。新的 MAPH 评分作为血液粘度的指标可以区分中枢性 APE 和外周性 APE。我们的结果意义重大，特别是对于检查有限的中心，因为它可以加速诊断和治疗过程。我们认为我们的结果可能会指导未来的调查。