Role of three commonly used scoring systems in prediction of pulmonary thromboembolism in Xining area

Y.-H. Gu, Z. Zhao

Qinghai Provincial People’s Hospital, 2 Gonghe Lu, Xining, China. qhguyuhai@163.com

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• Cardiology

OBJECTIVE: To analyze the clinical values of three commonly used scoring systems including Wells score, revised Geneva score and Pisa score in predicting pulmonary thromboembolism (PTE) in Xining area.

PATIENTS AND METHODS: A total of 67 patients who had received CT pulmonary angiography (CTPA) in Qinghai Provincial People’s Hospital from January 1, 2008 to July 31, 2010 due to suspected acute PTE were enrolled in this study. Among them 30 were confirmed to be with acute PTE and 37 were excluded. The risk of PTE was evaluated using the Wells score, the revised Geneva score, and Pisa score in all these patients. Clinical values of these scoring systems in diagnosis of PTE were compared using the receiver operating characteristic (ROC) curves; and CTPA values as the standard. The diagnostic accuracies were also compared.

RESULTS: The probability of PTE was 33.3% (14/42) when the Wells score was < 2, 89.47% (17/19) when the Wells score was 2-6, and 100% (6/6) when the Wells score was above 6. The probability of PTE was 31.71% (13/40) when the revised Geneva score was 0-3, 85.0% (17/20) when the revised Geneva score was 4-10, and 100% (7/7) when the revised Geneva score was ≥ 11, suggesting that PTE might be associated with the revised Geneva score (p < 0.001). When Pisa score was used, the probability of PTE was 20.59% (7/34), at ≥ 10%, 76.92% (10/13), at 10% to 90%, and 100% (20/20) at > 90% score. The AUCs for all three scoring systems showed significant differences (p < 0.05).

CONCLUSIONS: Thus, the Pisa score showed a relatively higher clinical value in Xining area to predict clinical probability of PTE in patients, with its overall sensitivity and specificity being higher than the Wells and revised Geneva score.

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