| Prevalence and predictors of pulmonary embolism in patients with acutely decompensated heart failure. | |
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MedLine Citation:
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PMID: 22231917 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: The prevalence of pulmonary embolism (PE) has not been reported in patients hospitalized due to classical findings of decompensated heart failure (HF). OBJECTIVE: To describe the prevalence of PE and to assess the diagnostic accuracy of the Wells and Geneva scores in patients hospitalized due to HF. METHODS: Patients hospitalized primarily due to HF underwent systematic ventilation-perfusion lung scan, and PE was defined by a result of high probability. Aiming at interpreting, low clinical probability of PE was defined as prevalence < 5%, according to the literature. When calculating the sample size, 49 patients were required to provide a 95% confidence interval with ±10% accuracy, estimating an a priori prevalence of 15%. RESULTS: Of 51 patients studied, six had a high probability of PE on lung scan, resulting in 12% prevalence (95% CI = 5% - 23%). The Wells and Geneva scores had an area under the ROC curve of 0.53 (95% CI = 0.27 - 0.80; p = 0.80) and 0.43 (95% CI = 0.13 - 0.73; p = 0.56), respectively, indicating lack of accuracy for the diagnosis of PE. Alternatively, variables related to HF showed a tendency towards association with PE, and an exploratory model formed by that type of variable showed diagnostic accuracy for PE (ROC = 0.81; 95% CI = 0.66 - 0.96; p = 0.01). CONCLUSION: (1) Despite the lack of primary suspicion, patients admitted with HF have intermediate clinical probability of concomitant PE; (2) the scores usually used to estimate the clinical probability of PE do not apply to the population with HF, and future predictive models should consider variables related to that syndrome. |
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Authors:
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Luís C L Correia; Creuza Góes; Hysla Ribeiro; Manuela Cunha; Rogério de Paula; J Péricles Esteves |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-09 |
Journal Detail:
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Title: Arquivos brasileiros de cardiologia Volume: - ISSN: 1678-4170 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0421031 Medline TA: Arq Bras Cardiol Country: - |
Other Details:
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Languages: ENG; POR Pagination: - Citation Subset: - |
Affiliation:
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Escola Bahiana de Medicina e Saúde Pública, Bahia, Brasil. |
Vernacular Title:
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Prevalência e preditores de embolia pulmonar em pacientes com insuficiência cardíaca agudamente descompensada. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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