Hassani Solmaz, Najaf Najafi Neshat, Khodadadi Amirhossein, Gandomi Fahimeh, Amini Mahnaz
Endocrine Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
J Cardiovasc Thorac Res. 2024;16(3):152-155. doi: 10.34172/jcvtr.32999. Epub 2024 Sep 20.
Pulmonary embolism (PE) is a potentially fatal condition. Several non-invasive clinical decision rules (CDRs) were developed for the safe exclusion of PE. All CDRs used to safely rule out PE have been created and tested within hospital or acute care environments. However, CDRs that are designed in one specific setting may not perform as effectively when used in a different setting. In this study, we aimed to compare the performance of four common CDRs; Wells Score, Simplified Wells Score, revised Geneva Score, and simplified revised Geneva Score.
This was a cross-sectional study in which patients suspected of PE presenting to Imam Reza Hospital or Ghaem Hospital were recruited from September 23, 2013, to March 19, 2016 in Mashhad, Iran. The specificity, sensitivity, and accuracy were utilized as metrics to compare the CDRs in our region.
Two hundred and forty patients were included in the study. The mean age of patients was 57.91±19.97 years, and 54.16% of them (n=130) were female. 120 patients were confirmed to have PE with CT angiography. Wells score showed the highest sensitivity (90.4%) and revised Geneva score represented the highest specificity (84.9%). The highest accuracy belongs to the simplified Wells score (62.3%).
In this study, we demonstrated that the Wells criteria with its high sensitivity, can be used as a score for screening, and the revised Geneva score with its high specificity, can be used in the second stage for healthy people who have been diagnosed as unhealthy by the Wells score.
肺栓塞（PE）是一种潜在的致命疾病。已制定了几种非侵入性临床决策规则（CDR）用于安全排除PE。所有用于安全排除PE的CDR都是在医院或急性护理环境中创建和测试的。然而，在一种特定环境中设计的CDR在不同环境中使用时可能效果不佳。在本研究中，我们旨在比较四种常见CDR的性能；Wells评分、简化Wells评分、修订版Geneva评分和简化修订版Geneva评分。
这是一项横断面研究，2013年9月23日至2016年3月19日在伊朗马什哈德的伊玛目礼萨医院或加姆医院招募疑似PE的患者。特异性、敏感性和准确性被用作指标来比较我们地区的CDR。
240名患者纳入研究。患者的平均年龄为57.91±19.97岁，其中54.16%（n = 130）为女性。120名患者经CT血管造影确诊为PE。Wells评分显示出最高的敏感性（90.4%），修订版Geneva评分表现出最高的特异性（84.9%）。最高的准确性属于简化Wells评分（62.3%）。
在本研究中，我们证明了具有高敏感性的Wells标准可作为筛查评分，而具有高特异性的修订版Geneva评分可用于第二阶段，针对那些被Wells评分诊断为不健康的健康人群。
