Predication Of Clinical Risk Factors Scoring System For Pulmonary Embolism

Objective To reduce misdiagnodsis and underdiagnosis rate of pulmonary embolism, the prediction of the revised Geneva score an Wells score for pulmonary embolism were compared and analyzed by reseiver operating characteristic curves. Methods Forty cases with suspected pulmonary embolism(PE) were collected in the Third Affiliated Hospital of Anhui Medical University from September 2012 to October 2014. The result of CTPA as the basis of diagnosis. Of which 17 cases with PE were clinical confirmed. Relevant clinical data were recorded, For all patients with suspected, application of Wells, Kaprini and the revised Geneva scores to rate of venous thromboembolism. The scores can be divided into low, medium and high three groups. Summarized and the analysis variables were input to SPSS17.0 for statistical analysis. reseiver operating characteristic(ROC) curves was used to evaluate the probability of PE by the Wells, Kaprini and the revised Geneva scores. Results 22.5% cases has a score which was less than 2 by Wells scores(9/40), 58% cases were between 2~6(23/40), 20% cases were more than 6(8/40);2.5% cases has a score which was not more than 3 by the revised Geneva scores(1/40), 75% cases were between 4~10(30/40), 22.5% cases were more than 11(9/40);7.5% cases has a score which was not more than 3 by the Kaprini scores(3/40), 77.5% cases were between 4~8(31/40), 15% cases were more than 9(6/40). The area under curve(AUC) of the ROC curve in the Wells,Geneva and Kaprini scores was 0.899±0.059,0.803±0.040 and 0.850±0.030, respectvely(P=0.000).The optimal cutoff value was 4 point in the Wells score, 6 point in the Wells score and 5 point in the Wells score.The Wells more than 4 point predicted PE with a sensitivity of94.12 % and specificity of 84.96%.The Geneva more than 6 point predicted PE with a sensitivity of 100% and specificity of 60.87%.The Kaprini more than 5 point predicted PE with a sensitivity of 100% and specificity of 26%.Wells score predicts the comprehensive assessment of sensitivity and specificity of pulmonary embolism effectiveness is better than Kaprini ratings, but weak in improved Geneva score. Conclusion Wells score, Kaprini score and improved Geneva score to the diagnosis of pulmonary embolism has good predictive value.