Predication Of Wells And Revised Geneva Scores For Pulmonary Embolism

Objectives:Discusses suitable scale for China’s pulmonary embolism patients.except to find a suitable scale of pulmonary embolism in China,To reduce misdiagnosis and underdiagnosis rate of pulmonary embolism.Methods:One hundred and fifty-three cases(153) with suspected pulmonary embolism (PE) were collected in the Affiliated Hospital of Bin Zhou University from December2009to December2012. Of which78cases with PE were clinically confirmed. Relevant clinical data were recorded, summarized and the analysis variables were input to SPSS18.0for statistical analysis. ROC curves was used to evaluate the performance of the Wells and the revised Geneva scores in predicting pulmonary embolism.Results:Fourteen patients had a low clinical probability of PE (Wells score<2points), of which0(0%) had proven PE. The prevalence of PE was49.5%in the111patients with intermediate probability (2-6points) and82.1%in the28patients with high probability (>6points)(P=0.000). The confirmed PE was33.3%in the48patients with a low probability (Geneva score0-3points),55.3%(52/94) in intermediate probability (4-10points),90.9%(10/11) in high probability (score≥11points)(P=0.000). The area under curve (AUC) of the ROC curve in the Wells and Geneva scores were0.770,0.773,The optimal cut off value was3.5points in the Wells score and5.5points in the Geneva score. The Wells score more than3.5points predicted PE with a sensitivity of76.9%and specificity of66.7%.The Geneva score more than5.5points predicted PE with a sensitivity of60.33%and specificity of82.7%. According to the95%confidence interval exists cross, we can judge The comparison of the area under curve between the Wells and the Geneva score no statistical difference. Conclusion:The Wells score and the revised Geneva score are beneficial to predict pulmonary embolism. The two scores were without statistical difference. The diagnostic strategy of patients with suspected pulmonary embolism is possibility evaluation firstly,the low clinical probability of two scores may combine D-Dimer test.CTPA is the second examination of patients with high D-Dimer test.CTPA is the first examination of middle and high probability patients.