Abstract: Poster Presentations |

A Useful Clinical Model to Predict Pulmonary Embolism among Patients with Acute Dyspnea FREE TO VIEW

Ju-Yi P. Chen, MD*; Ting-Hsing Chao, MD; Yueliang L. Guo, MD, MPH; Chih-Hsin Hsu, MD; Yao-Yi Huang, MD; Jyh-Hong Chen, MD, PhD; Li-Jen Lin, MD
Author and Funding Information

National Cheng Kung University Medical Center, Tainan, Taiwan ROC


Chest. 2004;126(4_MeetingAbstracts):877S. doi:10.1378/chest.126.1.54
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PURPOSE:  Developing a simple clinical prediction of pulmonary embolism (PE) among patients with acute dyspnea in the emergency room.

METHODS:  Fifty-six patients with diagnosis of PE and 92 consecutive patients without PE, both presented with acute dyspnea in emergency room, were enrolled in this study. Primary physicians in emergency room assessed the initial evaluation and interpretation of various laboratory findings. Some significantly independent predictors of PE were identified and integrated to a clinical model of pretest probability. The probability was categorized as low (<30%), intermediate (>30%, <70%), and high (>70%).

RESULTS:  Clinical parameters associated with increased likelihood of PE were female, unilateral low leg edema, high alveolar-arterial oxygen gradient, clear chest roentgenogram, and electrocardiographic findings of right ventricular strain. On the other hand, variables associated with decreased likelihood of PE included cough, chest tightness, and unclear breathing sound. 95% of patients with PE were categorized into high or low probability based on our clinical model. The positive predictive value for high probability and negative predictive value for low probability were 94.1% and 94.4%, respectively. Less than 5% patients were fit in the intermediate probability group.

CONCLUSION:  This simple and easily available prediction model was useful in estimating the pretest probability of PE in this clinical setting.

CLINICAL IMPLICATIONS:  This simple and easily available prediction model was useful in estimating the pretest probability of PE in this clinical setting.

DISCLOSURE:  J.P. Chen, None.

Wednesday, October 27, 2004

12:30 PM- 2:00 PM




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