Three Common Pulmonary Embolism Clinical Grading Methods Value Of Clinical Application In Xining Area

Objective: To study the clinical value of three common pulmonary embolism clinical grading methods(Wells score,revised Geneva score,Pisa score) for diagnosing in Xining Area.Method: Collect the People's hospital of Qinghai province January 1,2008 to 2010 July 31, clinical diagnosis were 37 cases,the PTE patients ,30 cases, not the PTE patients, use the currently used clinical scoring methods, records, summary, statistical analysis, comparison of three common grading methods of moderate altitude pulmonary embolism predictive value. According to the three scales, the probability of pulmonary embolism of every patient was analyzed and the patients were divided into the low, inter mediate and high probability group. The result of CT pulmonary angiography was used as the diagnostic gold standard of pulmonary embolism.Results:1)Forty-two patients had a low clinical probability of PTE Wells score<2 points of which33.3% (14/42) had proven PTE.The prevalence of PTE was 89.47% in the 19 patients with intermediate probability (2-6 points)and 100% in the 6 patients with high probability (>6 points )(P=0.000).The confirmed PTE was 31.71% in the 40 patients with a low probability revised Geneva score (0-3 points )85.0%(17/20) in intermediate probability (4-10 points), 100%(7/7) in high probability score 11 points (P<0. 001).Pisa score in 10% or less likely low-alcohol pulmonary embolism 20.59% (7/34), (>10%, less than or equal to 90%) moderate pulmonary embolism possibility 76.92% (10/13), (>90%) altitude pulmonary embolism possibility 100% (20/20). Score increased pulmonary embolism, greater likelihood (P< 0.001). 2)The area under curve AUC of the ROC curve in the Wells and revised Geneva scores was 0.716±0.066 and 0.791±0.057 respectively.The Wells score predicted PTE with a sensitivity of 62.16%and specificity of 80.0%.The revised Geneva score predicted PE with a sensitivity of 64.87%and specificity of 93.33%.The area under curve AUC of the ROC curve in the Pisa score was 0.881±0.041, with a sensitivity of 81.08% and specificity of 96.67%.The comparison of the area under curve between the Wells ,the revised Geneva score and the Pisa score had significant difference statistically (P<0.05).Conclusions: The Wells score,revised Geneva score and Pisa score ratings the diagnosis of the PTE all have good clinical value in Xining Area; Pisa rating overall sensitivity and specificity is superior to the ratings, Geneva score and Wells score.