Volume 20 Issue 4
Apr.  2022
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Article Navigation >  Chinese Journal of General Practice  > 2022  >  20(4): 555-559
WANG Yue-yue, XU Qi-xia, YAO Yu-ting, WANG Hang, CHEN Lei. Comparison of the predictive value of three scoring methods in the diagnosis of acute pulmonary embolism[J]. Chinese Journal of General Practice, 2022, 20(4): 555-559. doi: 10.16766/j.cnki.issn.1674-4152.002399
Citation: WANG Yue-yue, XU Qi-xia, YAO Yu-ting, WANG Hang, CHEN Lei. Comparison of the predictive value of three scoring methods in the diagnosis of acute pulmonary embolism[J]. Chinese Journal of General Practice, 2022, 20(4): 555-559. doi: 10.16766/j.cnki.issn.1674-4152.002399
shu

Comparison of the predictive value of three scoring methods in the diagnosis of acute pulmonary embolism

doi: 10.16766/j.cnki.issn.1674-4152.002399
  • 1.

    Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

Funds:

 2016YFC0905600

 Byycx20072

  • Received Date: 2021-11-19
    Available Online: 2022-08-20
    Abstract
  •   Objective  To examine the predictive value of YEARS algorithm in the diagnosis of acute pulmonary embolism and compare it with two traditional scores in order to find a more suitable scoring model for clinical suspected acute pulmonary embolism.  Methods  A retrospective analysis was performed on 676 inpatients admitted at the First Affiliated Hospital of Bengbu Medical College from April 2018 to December 2020 who had undergone computed tomographic pulmonary angiography (CTPA) examination due to clinical suspected acute pulmonary embolism. CTPA was used as the gold standard for the diagnosis of acute pulmonary embolism, and the predictive value of YEARS algorithm, simplified Wells score, modified Geneva score and combination of simplified Wells score with different D-dimer thresholds in the diagnosis of acute pulmonary embolism was compared.  Results  A total of 174 patients were diagnosed with pulmonary embolism by CTPA examination. The sensitivity and negative predictive values of the YEARS algorithm (89.66% and 90.72%) were higher than those of the simplified Wells scores (66.09% and 85.95%) and modified Geneva scores (62.07% and 83.33%). However, its specificity (35.06%) was lower than that of the simplified Wells (71.91%) and modified Geneva (65.74%) scores. The area under curve (AUC) of the simplified Wells score (0.690) was greater than that of the YEARS algorithm (0.624) and the modified Geneva score (0.639). The simplified Wells score had the highest diagnostic odds ratio (DOR, 4.99), followed by the YEARS algorithm (4.68) and the modified Geneva score (3.14). In addition, combining the thresholds of different D-dimers to simplify the Wells score, the results showed that combining the simplified Wells score with D-dimer ≥0.5 mg/L achieved the highest DOR(5.08).  Conclusion  The sensitivity and negative predictive value of YEARS algorithm are higher, but the diagnostic efficacy is slightly lower than that of the simplified Wells score. The simplified Wells score has the highest diagnostic efficacy, and combining the simplified Wells score with D-dimer ≥0.5 mg/L may help improve the efficacy of pulmonary embolism diagnosis.

     

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