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Values of the Wells and Revised Geneva Scores Combined with D-dimer in Diagnosing Elderly Pulmonary Embolism Patients
Guo, Dan-Jie; Zhao, Can; Zou, Ya-Dan; Huang, Xu-Hang; Hu, Jing-Min; Guo, Lin
关键词D-dimer Elderly Pulmonary Embolism Revised Geneva Score Wells Score
刊名CHINESE MEDICAL JOURNAL
2015-04-20
DOI10.4103/0366-6999.155085
128期:8页:1052-1057
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Medicine, General & Internal
研究领域[WOS]General & Internal Medicine
关键词[WOS]ALTERNATIVE DIAGNOSIS ; CLINICAL-OUTCOMES ; TASK-FORCE ; PROBABILITY ; PREDICTION ; RULE ; THROMBOSIS ; MODEL
英文摘要

Background: Pulmonary embolism (PE) can be difficult to diagnose in elderly patients because of the coexistent diseases and the combination of drugs that they have taken. We aimed to compare the clinical diagnostic values of the Wells score, the revised Geneva score and each of them combined with D-dimer for suspected PE in elderly patients.

Methods: Three hundred and thirty-six patients who were admitted for suspected PE were enrolled retrospectively and divided into two groups based on age (>= 65 or < 65 years old). The Wells and revised Geneva scores were applied to evaluate the clinical probability of PE, and the positive predictive values of both scores were calculated using computed tomography pulmonary arteriography as a gold standard; overall accuracy was evaluated by the area under the curve (AUC) of receiver operator characteristic curve; the negative predictive values of D-dimer, the Wells score combined with D-dimer, and the revised Geneva score combined with D-dimer were calculated.

Results: Ninety-six cases (28.6%) were definitely diagnosed as PE among 336 cases, among them 56 cases (58.3%) were >= 65 years old. The positive predictive values of Wells and revised Geneva scores were 65.8% and 32.4%, respectively (P < 0.05) in the elderly patients; the AUC for the Wells score and the revised Geneva score in elderly was 0.682 (95% confidence interval [CI]: 0.612-0.746) and 0.655 (95% CI: 0.584-0.722), respectively (P = 0.389). The negative predictive values of D-dimer, the Wells score combined with D-dimer, and the revised Geneva score combined with D-dimer were 93.7%, 100%, and 100% in the elderly, respectively.

Conclusions: The diagnostic value of the Wells score was higher than the revised Geneva score for the elderly cases with suspected PE. The combination of either the Wells score or the revised Geneva score with a normal D-dimer concentration is a safe strategy to rule out PE.

语种英语
WOS记录号WOS:000353563300011
引用统计
被引频次:6[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/55875
专题北京大学第二临床医学院_心血管内科
作者单位Peking Univ, Peoples Hosp, Dept Cardiol, Beijing 100044, Peoples R China
推荐引用方式
GB/T 7714
Guo, Dan-Jie,Zhao, Can,Zou, Ya-Dan,et al. Values of the Wells and Revised Geneva Scores Combined with D-dimer in Diagnosing Elderly Pulmonary Embolism Patients[J]. CHINESE MEDICAL JOURNAL,2015,128(8):1052-1057.
APA Guo, Dan-Jie,Zhao, Can,Zou, Ya-Dan,Huang, Xu-Hang,Hu, Jing-Min,&Guo, Lin.(2015).Values of the Wells and Revised Geneva Scores Combined with D-dimer in Diagnosing Elderly Pulmonary Embolism Patients.CHINESE MEDICAL JOURNAL,128(8),1052-1057.
MLA Guo, Dan-Jie,et al."Values of the Wells and Revised Geneva Scores Combined with D-dimer in Diagnosing Elderly Pulmonary Embolism Patients".CHINESE MEDICAL JOURNAL 128.8(2015):1052-1057.
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