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学科主题: 临床医学
题名:
Values of the Wells and Revised Geneva Scores Combined with D-dimer in Diagnosing Elderly Pulmonary Embolism Patients
作者: 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
发表日期: 2015-04-20
DOI: 10.4103/0366-6999.155085
卷: 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
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/55875
Appears in Collections:北京大学第二临床医学院_心血管内科_期刊论文

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作者单位: Peking Univ, Peoples Hosp, Dept Cardiol, Beijing 100044, Peoples R China

Recommended Citation:
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.
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