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Vol - 29, Issue - 01
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[This article belongs to Volume - 29, Issue - 01]
International Medical Journal
Journal ID
:
IMJ-13-12-2021-1091
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:
481
Title
:
Application of New Diagnostic Parameters in Clinically Suspected Pulmonary Embolism
Abstract
: To evaluate role of YEARS Algorithm and DAGMAR Score in patients presented into Emergency Department with suspected Pulmonary Embolism. A prospective study was carried out on 114 patients of both sex with clinically suspected Pulmonary Embolism (PE) presented in Emergency and Traumatology Department, Tanta University Hospital. We included Adult patients (aged ≥ 18 years) with clinically suspected pulmonary embolism [both of One or more Complain of (Chest pain - Dyspnea/Shortness of Breath - Cough - Hemoptysis – Syncope) and One or more risk factors of Pulmonary Embolism (other than Hypertension and Diabetes Mellitus)]. All included patients were evaluated using validated wells criteria as a conventional diagnostic strategy and new diagnostic parameters including YEARS Items and DAGMAR Score. Computed Tomography Pulmonary Angiography (CTPA) performed in all patients as a confirmatory tool. Both Wells Criteria (> 4) and YEARS Items (> 0) were highly specific for PE (82.35% and 78.82% Specificity). While High sensitivity quantitative D-Dimer test (> 0.5 μg/ml) was highly sensitive for PE (96.55% Sensitivity). DAGMAR Score was both Sensitive and Specific for PE (79.31% and 61.18% respectively). YEARS Algorithm is a safe new clinical decision rule that can be used instead of Wells Criteria without increasing percentage of missed pulmonary embolism. Adding DAGMAR Score to YEARS Items instead of using only D-Dimer test may result in decreasing number of required Computed Tomography Pulmonary Angiography (CTPA) without increasing number of missed cases.
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