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Tytuł pozycji:

Wells Score to Predict Pulmonary Embolism in Patients with Coronavirus Disease 2019.

Tytuł :
Wells Score to Predict Pulmonary Embolism in Patients with Coronavirus Disease 2019.
Autorzy :
Kirsch B; Division of General Internal Medicine, Department of Internal Medicine, The University of Texas, John P. and Kathrine G. McGovern School of Medicine, Houston.
Aziz M; Division of General Internal Medicine, Department of Internal Medicine, The University of Texas, John P. and Kathrine G. McGovern School of Medicine, Houston.
Kumar S; Division of General Internal Medicine, Department of Internal Medicine, The University of Texas, John P. and Kathrine G. McGovern School of Medicine, Houston.
Burke M; Division of General Internal Medicine, Department of Internal Medicine, The University of Texas, John P. and Kathrine G. McGovern School of Medicine, Houston.
Webster T; Division of General Internal Medicine, Department of Internal Medicine, The University of Texas, John P. and Kathrine G. McGovern School of Medicine, Houston.
Immadi A; Division of General Internal Medicine, Department of Internal Medicine, The University of Texas, John P. and Kathrine G. McGovern School of Medicine, Houston.
Sam M; Division of General Internal Medicine, Department of Internal Medicine, The University of Texas, John P. and Kathrine G. McGovern School of Medicine, Houston.
Lal A; Division of General Internal Medicine, Department of Internal Medicine, The University of Texas, John P. and Kathrine G. McGovern School of Medicine, Houston.
Estrada-Y-Martin RM; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, The University of Texas, John P. and Kathrine G. McGovern School of Medicine, Houston.
Cherian S; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, The University of Texas, John P. and Kathrine G. McGovern School of Medicine, Houston.
Aisenberg GM; Division of General Internal Medicine, Department of Internal Medicine, The University of Texas, John P. and Kathrine G. McGovern School of Medicine, Houston. Electronic address: .
Pokaż więcej
Źródło :
The American journal of medicine [Am J Med] 2021 May; Vol. 134 (5), pp. 688-690. Date of Electronic Publication: 2020 Dec 11.
Typ publikacji :
Journal Article
Język :
English
Imprint Name(s) :
Publication: New York, NY : Excerpta Medica
Original Publication: New York, Donnelly.
MeSH Terms :
COVID-19*/blood
COVID-19*/complications
COVID-19*/diagnosis
COVID-19*/epidemiology
Computed Tomography Angiography/*methods
Fibrin Fibrinogen Degradation Products/*analysis
Pulmonary Embolism/*diagnosis
Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Pulmonary Embolism/blood ; Pulmonary Embolism/epidemiology ; Pulmonary Embolism/etiology ; ROC Curve ; Research Design/standards ; Retrospective Studies ; SARS-CoV-2 ; Sensitivity and Specificity ; Severity of Illness Index ; Thrombophilia/diagnosis ; Thrombophilia/etiology ; United States/epidemiology
Contributed Indexing :
Keywords: COVID-19*; D-dimer*; Pulmonary embolism*; Wells score*
Substance Nomenclature :
0 (Fibrin Fibrinogen Degradation Products)
0 (fibrin fragment D)
Entry Date(s) :
Date Created: 20201214 Date Completed: 20210517 Latest Revision: 20210517
Update Code :
20210518
PubMed Central ID :
PMC7732230
DOI :
10.1016/j.amjmed.2020.10.044
PMID :
33316254
Czasopismo naukowe
Background: The association between coronavirus disease 2019 (COVID-19) and hypercoagulability has been extensively described, and pulmonary embolism is a recognized complication of COVID-19. Currently, the need for computed tomography pulmonary angiogram (CTPA) relies on the Wells score and serum D-dimer levels. However, because COVID-19 patients have a different thrombotic and inflammatory milieu, the usefulness of the Wells score deserves further exploration for this patient population. We aimed to explore the ability of the Wells score to predict pulmonary embolism in patients with COVID-19.
Methods: In this retrospective study, patients found to have a CTPA and a COVID-19 diagnosis during the same admission were selected for analysis. Age and sex, CTPA results, and associated D-dimer levels were entered in a database. The Wells score sensitivity and specificity were calculated at different values, and the area under the curve of the receiver operating characteristic curve measured.
Results: Of 459 patients with COVID-19, 64 had a CTPA and 12 (19%) had evidence of pulmonary embolism. Previous or current evidence of deep vein thrombosis, a Wells score above 4 points, and serum D-dimer levels 5 times above age-adjusted upper normal values were associated with pulmonary embolism. However, only 33% of patients with pulmonary embolism had a Wells score of 4 points or higher. The area under the curve of the receiver operating characteristic showed non-discriminating values (0.54) CONCLUSIONS: Although a Wells score of 4 or more points predicted pulmonary embolism in our cohort, the outcome can be present even with lower scores.
(Copyright © 2020 Elsevier Inc. All rights reserved.)

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