Comparison of the screening effects between Wells and revised Geneva scores on suspected acute pulmonary thromboembolism
10.3760/cma.j.issn.1671-0282.2012.03.015
- VernacularTitle:Wells与修正Geneva评分急诊筛查肺栓塞的比较
- Author:
Weicheng WU
;
Jiyan LIN
;
Chengbin YANG
;
Yuzhen WU
;
Xiangmei YU
;
Jiaquan LIU
;
Zili ZHANG
- Publication Type:Journal Article
- Keywords:
Acute pulmonary thromboembolism;
Screening;
Wells score;
Revised Geneva score
- From:
Chinese Journal of Emergency Medicine
2012;21(3):282-285
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the screening effects between Wells and revised Geneva scores on suspected acute pulmonary thromboembolism (APTE),and to explore a optimum screening method for APTE in the emergency department of China.Methods The study was carried out by using random,crossed,prospective methods to compare the screening effects between Wells and revised Geneva scores for 167 suspected APTE patients in the emergency department of the First Affiliated Hospital of Xiamen University.Results The areas under the receiver operating characteristic curve of Wells and revised Geneva scores for screening APTE in the emergency department were (0.917 ± 0.022 ) and (0.927 ± 0.020),respectively ( P ＜ 0.05 ).The diagnostic concordance between the two score systems for predicting APTE was poor (Kappa value =0.276 ). In addition, the difference between their hierarchical discrimination for the possibility of APTE was statistically significant ( P ＜ 0.05 ).Compared with revised Geneva score,fewer patients were diagnosed with low clinical probability of APTE and more patients were diagnosed with intermediate or high clinical probability of APTE through Wells score.The patients with low chnical probability of APTE were excluded from pulmonary embolism in Wells or revised Geneva score.At intermediate clinical probability,the accuracy rate of Wells score for predicting APTE (9.64％) was lower than that (32.84％ ) of revised Geneva ( P ＜ 0.05 ).At high clinical probability,there was no significant difference between their accuracy rate [ (67.24％ vs.86.21％),P＞0.05]. Conclusions Revised Geneva score is more suitable than Wells score in screening suspected APTE patients in the emergency department in our country.
