Department of Anaesthesiology, Intensive Care and Emergency Medical Services (SAMU 76), Rouen University Hospital, Rouen.
Emergency Department, Elbeuf Hospital, Saint Aubin les elbeufs.
Eur J Emerg Med. 2020 Oct;27(5):357-361. doi: 10.1097/MEJ.0000000000000680.
Chest pain is a common main complaint in the emergency department. Among its associated differential diagnoses, pulmonary embolism remains a key concern for the clinician. There are no clear recommendations on which patients should have a formal workup for pulmonary embolism diagnosis. The objective of this study was to determine the proportion of patients with chest pain who were investigated for pulmonary embolism diagnosis and to determine the clinical profile of these patients.
This was a retrospective multicenter study conducted in three French Emergency Departments. We included all patients who presented to these centers for chest pain during a 2-month period. The primary outcome was the initiation of pulmonary embolism workup. We also aimed to find factors associated with this outcome.
We included 881 patients with a main complaint of chest pain. Mean age was 50 years and 481 (56%) were men. A total of 263 patients (30%, 95% confidence interval 27-33%) had a formal pulmonary embolism workup, and pulmonary embolism was ultimately diagnosed in 7 cases (prevalence of 2.6%, 95% confidence interval 1.1-5.3%). Five factors were identified as independently associated with a workup for pulmonary embolism diagnosis: female sex, young age, no ischemic heart disease, recent flight and associated dyspnea.
Among patients presenting to emergency department with chest pain, 30% had a workup for pulmonary embolism. We report five clinical variables independently associated with a higher probability of pulmonary embolism workup in our sample.
胸痛是急诊科常见的主要主诉。在其相关的鉴别诊断中，肺栓塞仍然是临床医生关注的重点。对于哪些患者应进行正式的肺栓塞诊断检查，目前尚无明确的建议。本研究的目的是确定有胸痛症状的患者中进行肺栓塞诊断检查的比例，并确定这些患者的临床特征。
这是一项在法国三个急诊科进行的回顾性多中心研究。我们纳入了在这三个中心因胸痛就诊的所有患者。主要结局是开始进行肺栓塞检查。我们还旨在寻找与该结局相关的因素。
我们纳入了 881 例以胸痛为主诉的患者。平均年龄为 50 岁，其中 481 例（56%）为男性。共有 263 例（30%，95%置信区间 27-33%）进行了正式的肺栓塞检查，最终诊断为 7 例肺栓塞（患病率为 2.6%，95%置信区间 1.1-5.3%）。有五个因素被确定为与肺栓塞诊断检查独立相关：女性、年轻、无缺血性心脏病、近期飞行和伴随呼吸困难。
在因胸痛就诊急诊科的患者中，有 30%进行了肺栓塞检查。我们报告了五个与我们样本中肺栓塞检查可能性更高相关的临床变量。
