Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, Sichuan, China.
Int J Gynaecol Obstet. 2024 Oct;167(1):374-382. doi: 10.1002/ijgo.15573. Epub 2024 May 15.
To evaluate the effectiveness of the YEARS algorithm for excluding pulmonary embolism (PE) in hospitalized women after cesarean section.
This retrospective study included postpartum women who gave birth by cesarean section and received computed tomography pulmonary angiography (CTPA) because of suspected PE in the obstetric department between 2015 and 2021. We used the YEARS algorithm in these women retrospectively and assessed its performance to evaluate whether the algorithm could be reliably applied in such cases.
In all, 225 women were included in the study, of whom 29 (12.9%) women were positive for PE according to the results of CTPA. Upon retrospective application of the YEARS algorithm, 188 (83.6%) women had no YEARS items, while 37 (16.4%) women had YEARS items. Combining the results with D-dimer levels revealed that only 12 (5.3%) women did not need to undergo CTPA, and none showed PE.
The YEARS algorithm could be applied to exclude PE in hospitalized women in the early post-cesarean period. However, the specificity of the YEARS algorithm was very low, and the D-dimer cut-off for ruling out PE in women after early cesarean section should be further studied and optimized.
评估 YEARS 算法在排除剖宫产术后住院女性肺栓塞（PE）中的有效性。
本回顾性研究纳入了 2015 年至 2021 年间因产科疑似 PE 而在妇产科接受计算机断层肺动脉造影（CTPA）的剖宫产术后女性。我们对这些女性进行了 YEARS 算法的回顾性评估，并评估了其性能，以确定该算法是否可在这种情况下可靠应用。
共纳入 225 名女性，其中 29 名（12.9%）女性根据 CTPA 结果呈 PE 阳性。通过 YEARS 算法的回顾性应用，188 名（83.6%）女性没有 YEARS 项目，而 37 名（16.4%）女性有 YEARS 项目。将结果与 D-二聚体水平相结合表明，仅 12 名（5.3%）女性无需进行 CTPA，且无一例出现 PE。
YEARS 算法可用于排除剖宫产术后早期住院女性的 PE。然而，YEARS 算法的特异性非常低，应进一步研究和优化用于排除早期剖宫产术后女性 PE 的 D-二聚体截断值。
