| Assessing clinical probability of pulmonary embolism in the emergency ward: a simple score. | |
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MedLine Citation:
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PMID: 11146703 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To develop a simple standardized clinical score to stratify emergency ward patients with clinically suspected pulmonary embolism (PE) into groups with a high, intermediate, or low probability of PE to improve and simplify the diagnostic approach. METHODS: Analysis of a database of 1090 consecutive patients admitted to the emergency ward for suspected PE in whom diagnosis of PE was ruled in or out by a standard diagnostic algorithm. Logistic regression was used to predict clinical parameters associated with PE. RESULTS: A total of 296 (27%) of 1090 patients were found to have PE. The optimal estimate of clinical probability was based on 8 variables: recent surgery, previous thromboembolic event, older age, hypocapnia, hypoxemia, tachycardia, band atelectasis, or elevation of a hemidiaphragm on chest x-ray film. A probability score was calculated by adding points assigned to these variables. A cutoff score of 4 best identified patients with low probability of PE. A total of 486 patients (49%) had a low clinical probability of PE (score </=4), of which 50 (10.3%) had a proven PE. The prevalence of PE was 38% in the 437 patients with an intermediate probability (score of 5-8; n = 437) and 81% in the 63 patients with a high probability (score >/=9). CONCLUSIONS: This clinical score, based on easily available and objective variables, provides a standardized assessment of the clinical probability of PE. Applying this score to emergency ward patients suspected of having PE could allow a more effective diagnostic process. |
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Authors:
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J Wicki; T V Perneger; A F Junod; H Bounameaux; A Perrier |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Archives of internal medicine Volume: 161 ISSN: 0003-9926 ISO Abbreviation: Arch. Intern. Med. Publication Date: 2001 Jan |
Date Detail:
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Created Date: 2001-01-18 Completed Date: 2001-01-18 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0372440 Medline TA: Arch Intern Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 92-7 Citation Subset: AIM; IM |
Affiliation:
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Medical Clinic 1, Department of Internal Medicine, Geneva University Hospital, 24 Rue Micheli-du-Crest, CH-1211 Geneva 14, Switzerland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Algorithms Databases as Topic Decision Support Techniques* Emergency Service, Hospital* Female Humans Male Middle Aged Probability Pulmonary Embolism / diagnosis* Regression Analysis |
| Comments/Corrections | |
Comment In:
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Arch Intern Med. 2001 Aug 13-27;161(15):1925-6
[PMID:
11493155
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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