The application of a clinical risk stratification score may reduce unnecessary investigations for pulmonary embolism in pregnancy

OConnorC.; MoriartyJ.; WalshJ.; MurrayJ.; Coulter-SmithS.; BoydW.

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The application of a clinical risk stratification score may reduce unnecessary investigations for pulmonary embolism in pregnancy

机译：临床风险分层评分的应用可能会减少不必要的妊娠肺栓塞检查

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Objective: To examine the use of the modified Wells score in pregnancy as a risk stratification tool in the diagnosis of pulmonary embolism (PE). Methods: All pregnant or post-partum patients who were referred for CT Pulmonary Angiography (CTPA) to evaluate suspected PE over a 5-year period were included in the study. Patient records were used to apply the modified Wells score (MWS) and analyze their risk of PE. Results: A total of 125 women were referred for CTPA over 5 years. A MWS of 6 or greater ("High Risk") was 100% sensitive and 90% specific with a positive predictive value of 36% for PE on CTPA. No patients with a low MWS (less than 6) had a PE, giving a negative predictive value of 100%. p≤0.001. D-dimers, chest X-ray, blood gases and EKG were significantly less effective than the MWS in aiding the diagnosis of PE. Conclusion: Current methods employed for the diagnosis of PE are inadequate. Risk stratification using the MWS may allow safe exclusion of PE before resorting to CTPA. To the best of our knowledge this is the first study to have used the MWS in a pregnant patient group.

机译：目的：探讨妊娠期改良的Wells评分作为诊断肺栓塞（PE）的危险分层工具的用途。方法：本研究包括所有接受了CT肺血管造影（CTPA）评估5年可疑PE的孕妇或产后患者。使用患者记录来应用修正的Wells评分（MWS）并分析其发生PE的风险。结果：5年中共有125名女性被推荐接受CTPA治疗。 MWS为6或更高（“高风险”）的患者对CTPA的PE敏感度为100％，特异性为90％，阳性预测值为36％。 MWS低（小于6）的患者均无PE，其阴性预测值为100％。 p≤0.001。 D-二聚体，胸部X光片，血气和心电图在诊断PE方面远不及MWS有效。结论：目前用于诊断PE的方法还不够。使用MWS进行风险分层可允许在诉诸CTPA之前安全排除PE。据我们所知，这是第一个在孕妇组中使用MWS的研究。

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《The journal of maternal-fetal & neonatal medicine》 |2011年第12期|共4页
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OConnorC.; MoriartyJ.; WalshJ.; MurrayJ.; Coulter-SmithS.; BoydW.;
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中图分类产科学;
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CT pulmonary angiography; Modified Wells score; Pregnancy; Pulmonary embolism; Venous thromboembolism;

机译：CT肺血管造影;改良的Wells评分;妊娠;肺栓塞;静脉血栓栓塞;

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1. The application of a clinical risk stratification score may reduce unnecessary investigations for pulmonary embolism in pregnancy [J] . OConnorC., MoriartyJ., WalshJ., The journal of maternal-fetal & neonatal medicine . 2011,第12期

机译：临床风险分层评分的应用可能会减少不必要的妊娠肺栓塞检查
2. Comparing the pulmonary embolism severity index and the prognosis in pulmonary embolism scores as risk stratification tools [J] . ChanC.M., WoodsC.J., ShorrA.F. Journal of Hospital Medicine . 2012,第1期

机译：比较肺栓塞严重程度指数和肺栓塞评分的预后作为危险分层工具
3. A strategy combining imaging and laboratory biomarkers in comparison with a simplified clinical score for risk stratification of patients with acute pulmonary embolism [J] . LankeitM., GómezV., WagnerC., Chest: The Journal of Circulation, Respiration and Related Systems . 2012,第4期

机译：结合影像学和实验室生物标志物以及简化的临床评分对急性肺栓塞患者进行风险分层的策略
4. Study of ventricular interaction during pulmonary embolism using clinical identification in a minimum cardiovascular system model [C] . Desaive, T., Ghuysen, Engineering in Medicine and Biology Society, 2007 Annual International Conference of the IEEE . 2007

机译：在最小心血管系统模型中使用临床鉴定研究肺栓塞期间的心室相互作用
5. The qSOFA for Lung Nodules: Using Age and Three Chest CT Findings Combined for Early Identification and Risk Stratification of Patients with Incidental Pulmonary Nodules in a Safety Net Hospital [D] . Rey Mendoza, Juan Pablo. 2019

机译：肺结核的QSOFA：使用年龄和三胸CT调查结果，用于安全网医院偶然肺结核患者的早期鉴定和风险分层
6. Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism [O] . Jan Bĕlohlávek, Vladimír Dytrych, Aleš Linhart 2001

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The application of a clinical risk stratification score may reduce unnecessary investigations for pulmonary embolism in pregnancy

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