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RESEARCH PRODUCT
Pulmonary embolism in an emergency care unit of Southern Italy: Evaluation of predictive factors from clinical history and physical exam
Eugenia HoppsMaurizio AvernaFrancesco BrocatoVincenzo Maria PaternoDavide NotoRosario SquatritoAntonina GiammancoEmanuela FertittaBaldassare Caninosubject
medicine.medical_specialtybiologyTroponin Tbusiness.industryC-reactive proteinChest painmedicine.diseaseThrombosisPulmonary embolismBlood pressureRespiratory failureEmergency medicinemedicinebiology.proteinmedicine.symptomIntensive care medicinebusinessGeneva scoredescription
An early diagnosis of pulmonary embolism (PE) improves outcome. Therefore, PE should be diagnosed in Emergency Care Units (ECU) at admission. Clinical algorithms support the clinician in this task, although performance is biased by differences in risk factors prevalent in different populations. The clinical conditions predictive of PE were evaluated in subjects from Southern Italy accessing ECU for dyspnea/chest pain. Retrospective clinical data were obtained by electronic retrieving from a hospital database. Data from 8177 patients (age 18-90 years, 54 with PE) were collected from years 2007-2013. Previous history of PE, thrombosis and/or phlebitis, rheumatic diseases, respiratory failure, low blood pressure, pulse oxymetry rate (SpO 2 ) and high heart rate were associated with PE diagnosis. High white blood count with neutrophilia, C reactive protein, D-dimer, NT-pro-BNP determinations, but not troponin T, were associated with PE. Recalibration of the GENEVA score and its modification, by inclusion of novel risk factors, improved the algorithm performance (GENEVA AROC=0.730, modified GENEVA AROC = 0.792, DeLong9s test p =
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2016-09-01 | 2.1 Acute Critical Care |