The Clinical Study Of WELLS And PESI Score In Predicting The Severity And Prognosis Of Patients With APE

OBJECTIVE:To access the value of pulmonary embolism severity index score and the WELLS score on the patients with acute pulmonary embolism, also to analyze clinical characteristics and risk factor in patients with pulmonary embolism.METHODS:Two hospitals (xiangya hospital of center south university and the center hospital of Changsha city)in china were selected as study setting. The patients with PE admitted to those two hospitals are enrolled in study between July 2002 and January 2011. record all the data when the patients admitted.Including age, sex, heart rate, blood pressure, breathing rate, temperature, mind, symptom, arterial oxygen saturation value, heart failure or no, chronic lung disease, tumor or no, DVT or no. Scored those patients with PESI and WELLS score. Get their prognosis by medical recorded or a phone call. Analyze clinical characteristics and risk factors of the PE patients, investigate the relation between risk factor and pulmonary embolism. Using basic statistics to explore the value of these two systems in evaluating the PE patients.RESULTS:1.The PE patients'common clinical features include dyspnea, chest pain, emptysis, heart-throp, high heart-rate, high breath-rate and so on. Its incidence is 35.3%,31.8%,31.8%,28.2%,41.2%,21.2%respectively; the risk factors of PE patients include immobility or major surgery in four week, chronic lung disease, tumor, its incidence is 61.2%,49.4%,18.8% respectively; between PE group and the non-PE group the age, chest pain, immobility or operated in four weeks and heart failure have some connection with PE (P< 0.05)2. The WELLS score between PE group and the non-PE group was different (P<0.05), but in predicting prognosis, it had no markedly different between the two groups.3.Among the 85 PE patients, it have 19 persons in class one,25 in class two,14 in class there,12 in class four,15 in class five, its ratio is 22%,29%,17%,14%,18%respectively, the survival time between different group varied markedly.CONCLUSIONS:The PE patients'clinical features are nonspecific. The WELLS score is helpful in diagnosing PE, but have no indicate effect in making prognosis of PE patients. The higher the level of PESI when the patient admitted, the higher the mortality rate, the PESI class can predict the patients prognosis well.