Document Detail


A simplified clinical model to predict pulmonary embolism in patients with acute dyspnea.
MedLine Citation:
PMID:  16607053     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PATIENTS AND MEASUREMENTS: We enrolled 56 patients diagnosed with PE, and 92 consecutive patients without PE, all of whom presented with acute dyspnea in the emergency room. Primary emergency-room physicians assessed the initial evaluation and interpretation of various laboratory findings. Some significantly independent predictors of PE were identified and integrated into a clinical model of pretest probability: low (< 30%), intermediate (>or= 30%, <or= 70%), and high (> 70%). After setting up the model, another 40 patients (16 with PE, 24 without PE) were tested using the pretest model. Clinical variables associated with an increased likelihood of PE were being female and having unilateral low-leg edema, a high alveolar-arterial oxygen gradient, a clear chest x-ray, and electrocardiographic findings of right ventricular strain. Variables associated with a decreased likelihood of PE were cough, chest tightness, and unclear breath sounds. Our clinical model predicted that 95% of patients with PE had a high or low probability of PE. The positive predictive value for high probability was 94.1% and the negative predictive value for low probability was 94.4%. In the tested group, the positive predictive value for high probability was 92.9%. The negative predictive value for low probability was 91.3%. This simple and easily available prediction model was useful for estimating the pretest probability of PE in patients with acute dyspnea.
Authors:
Ju-Yi Chen; Ting-Hsing Chao; Yue-Liang Guo; Chih-Hsin Hsu; Yao-Yi Huang; Jyh-Hong Chen; Li-Jen Lin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International heart journal     Volume:  47     ISSN:  1349-2365     ISO Abbreviation:  Int Heart J     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-04-11     Completed Date:  2006-10-31     Revised Date:  2014-07-29    
Medline Journal Info:
Nlm Unique ID:  101244240     Medline TA:  Int Heart J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  259-71     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Aged, 80 and over
Blood Gas Analysis
Dyspnea / complications*
Echocardiography, Doppler, Color
Echocardiography, Transesophageal
Electrocardiography
Female
Forecasting
Humans
Male
Middle Aged
Models, Statistical*
Predictive Value of Tests
Probability
Pulmonary Embolism / diagnosis*
Radiography, Thoracic
Regression Analysis
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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