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A study of modified Wells score for pulmonary embolism and age-adjusted D-dimer values in patients at risk for deep venous thrombosis

AIMS: Pulmonary embolism (PE) is the most severe complication of deep venous thrombosis (DVT). This study was designed to evaluate the usefulness of modified Wells score combined with age-adjusted D-dimer cut-off levels as a clinical pre-test probability assessment for predicting PE in patients ‘at...

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Autores principales: Singh, Sweety, Goel, Atul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657094/
https://www.ncbi.nlm.nih.gov/pubmed/38024920
http://dx.doi.org/10.4103/jfmpc.jfmpc_2455_22
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author Singh, Sweety
Goel, Atul
author_facet Singh, Sweety
Goel, Atul
author_sort Singh, Sweety
collection PubMed
description AIMS: Pulmonary embolism (PE) is the most severe complication of deep venous thrombosis (DVT). This study was designed to evaluate the usefulness of modified Wells score combined with age-adjusted D-dimer cut-off levels as a clinical pre-test probability assessment for predicting PE in patients ‘at risk for DVT.’ METHODS: This was a cross-sectional study including 200 in-patients at risk for DVT. Patients were categorized as ‘pulmonary embolism unlikely’ or ‘pulmonary embolism likely’ using modified Wells score and underwent D-dimer testing. PE was considered excluded in patients classified as unlikely with normal D-dimer levels, whereas the rest of the patients underwent computed tomography pulmonary angiogram (CTPA). RESULTS: Out of 200 patients, 163 patients (81.50%) were ‘pulmonary embolism unlikely,’ whereas 37 patients (18.50%) were ‘pulmonary embolism likely.’ Of 163 patients categorized as ‘pulmonary embolism unlikely,’ 67 patients (41.5%) had normal D-dimer values and were excluded from CTPA. PE was detected in 24.2% of the patients who underwent CTPA. CONCLUSION: The combined strategy using modified Wells score and age-adjusted D-dimer cut-off value has 100% sensitivity and a negative predictive value and can be used to safely exclude PE in in-patients.
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spelling pubmed-106570942023-09-01 A study of modified Wells score for pulmonary embolism and age-adjusted D-dimer values in patients at risk for deep venous thrombosis Singh, Sweety Goel, Atul J Family Med Prim Care Original Article AIMS: Pulmonary embolism (PE) is the most severe complication of deep venous thrombosis (DVT). This study was designed to evaluate the usefulness of modified Wells score combined with age-adjusted D-dimer cut-off levels as a clinical pre-test probability assessment for predicting PE in patients ‘at risk for DVT.’ METHODS: This was a cross-sectional study including 200 in-patients at risk for DVT. Patients were categorized as ‘pulmonary embolism unlikely’ or ‘pulmonary embolism likely’ using modified Wells score and underwent D-dimer testing. PE was considered excluded in patients classified as unlikely with normal D-dimer levels, whereas the rest of the patients underwent computed tomography pulmonary angiogram (CTPA). RESULTS: Out of 200 patients, 163 patients (81.50%) were ‘pulmonary embolism unlikely,’ whereas 37 patients (18.50%) were ‘pulmonary embolism likely.’ Of 163 patients categorized as ‘pulmonary embolism unlikely,’ 67 patients (41.5%) had normal D-dimer values and were excluded from CTPA. PE was detected in 24.2% of the patients who underwent CTPA. CONCLUSION: The combined strategy using modified Wells score and age-adjusted D-dimer cut-off value has 100% sensitivity and a negative predictive value and can be used to safely exclude PE in in-patients. Wolters Kluwer - Medknow 2023-09 2023-09-30 /pmc/articles/PMC10657094/ /pubmed/38024920 http://dx.doi.org/10.4103/jfmpc.jfmpc_2455_22 Text en Copyright: © 2023 Journal of Family Medicine and Primary Care https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Singh, Sweety
Goel, Atul
A study of modified Wells score for pulmonary embolism and age-adjusted D-dimer values in patients at risk for deep venous thrombosis
title A study of modified Wells score for pulmonary embolism and age-adjusted D-dimer values in patients at risk for deep venous thrombosis
title_full A study of modified Wells score for pulmonary embolism and age-adjusted D-dimer values in patients at risk for deep venous thrombosis
title_fullStr A study of modified Wells score for pulmonary embolism and age-adjusted D-dimer values in patients at risk for deep venous thrombosis
title_full_unstemmed A study of modified Wells score for pulmonary embolism and age-adjusted D-dimer values in patients at risk for deep venous thrombosis
title_short A study of modified Wells score for pulmonary embolism and age-adjusted D-dimer values in patients at risk for deep venous thrombosis
title_sort study of modified wells score for pulmonary embolism and age-adjusted d-dimer values in patients at risk for deep venous thrombosis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657094/
https://www.ncbi.nlm.nih.gov/pubmed/38024920
http://dx.doi.org/10.4103/jfmpc.jfmpc_2455_22
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