在急诊科使用预测量表诊断肺血栓栓塞症。
Use of predictive scales for pulmonary thromboembolism in an emergency department.
机构信息
Servicio de Urgencias, Hospital Universitario del Henares, Coslada, Madrid, España.
Servicio de Urgencias, Hospital Universitario del Henares, Coslada, Madrid, España.
出版信息
Med Clin (Barc). 2022 Nov 25;159(10):483-485. doi: 10.1016/j.medcli.2022.03.016. Epub 2022 Jun 6.
BACKGROUND AND OBJECTIVE
Diagnosing pulmonary thromboembolism (PTE) is difficult. Clinical probability scales (CPS) can help. The aim is to find out which one is the best.
PATIENTS AND METHODS
A retrospective cross-sectional single-center study was conducted. It evaluated four CPS (Pulmonary Embolism Rule Out Criteria [PERC], Wells, Geneva, and YEARS criteria) validity in 200 patients who underwent computerized tomography angiography of the pulmonary arteries. Their degree of use was estimated, as well as the possible correlation between them and DD (D dimer).
RESULTS
The four CPS have a high sensitivity, close to 1 and without differences between them. The YEARS scale is between 2 and 4 times more specific than the others. The degree of use of the scales was estimated at 14% (95% CI: 9.19-18.81). A weak positive correlation was found between the scores on the Wells and Geneva scales and the DD.
CONCLUSIONS
The YEARS scale is shown to be better than the others due to its potential greater number of imaging tests avoided and the degree of application of the CPS could be improved.
背景与目的
诊断肺血栓栓塞症（PTE）具有一定难度。临床概率评分（CPS）有助于诊断。本研究旨在明确哪种评分系统最佳。
患者与方法
这是一项回顾性、横断面、单中心研究。研究纳入了 200 例行肺动脉计算机断层血管造影术的患者，评估了四种 CPS（肺栓塞排除标准[PERC]、Wells、Geneva 和 YEARS 标准）的有效性。评估了这些评分系统的使用程度，以及它们与 D-二聚体（DD）之间可能的相关性。
结果
四种 CPS 的敏感性均较高，接近 1，且无明显差异。YEARS 评分的特异性比其他评分系统高 2 至 4 倍。这些评分系统的使用程度估计为 14%（95%CI：9.19-18.81）。Wells 和 Geneva 评分与 DD 之间呈弱正相关。
结论
与其他评分系统相比，YEARS 评分系统的优势在于能避免更多的影像学检查，且 CPS 的应用程度可能会提高。
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