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《Journal of Bethune Medical Science》 2014-04
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Predication of Wells and revised Geneva score for pulmonary embolism

MA Yuxia;LIU Yi;WANG Pengsheng;Department of Geratology,Central Hospital of Cangzhou;  
Objective To reduce misdiagnosis and underdiagnosis rates of pulmonary embolism,the prediction of the Wells score and revised Geneva score for pulmonary embolism were compared and analyzed by receiver operating characteristic curves. Methods Six hundred and thirty-seven cases with suspected pulmonary embolism( PE) were collected,among whom 256 cases with PE were clinically confirmed. Before CTPA test or on condition that test results were unknown,clinical scoring was assessed prospectively by the Wells score and the Revised Geneva score. ROC curves was used to evaluate the probability of PE predicted by the Wells and the revised Geneva scores. Results The prevalence of PE was 7. 7% with a low clinical probability( Wells Score 2 points). The prevalence of PE was 57. 3% with intermediate probability( 2- 6 points) and 83. 3% with high probability( 6 points). The confirmed PE was 12. 1% with a low probability( Geneva score 0- 3 points),46. 6% in intermediate probability( 4- 10 points),60. 0% in high probability( score≥11 points). The area under curve( AUC) of the ROC curve in the Wells and Geneva scores was 0. 849( 95% Cl:0. 817- 0. 881) and 0. 813( 95% Cl: 0. 778- 0. 849). Optimal cut off value was 2. 75 points in the Wells Score and 6. 5 points in the Geneva score. The comparison of the area under curve between the Wells and the Geneva score had a statistically signifcant difference( P 0.05). Conclusion The Wells score and the revised Geneva score are valuable in prediction of pulmonary embolism. The Wells score is generally superior to the revised Geneva score.
【Fund】: 河北省沧州市科技项目基金资助课题(1213056ZD)
【CateGory Index】: R563.5
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