A study of modified Wells score for pulmonary embolism and age-adjusted D-dimer values in patients at risk for deep venous thrombosis
Aims: Pulmonary embolism (PE) is the most severe complication of deep venous thrombosis (DVT). This study was designed to evaluate the usefulness of modified Wells score combined with age-adjusted D-dimer cut-off levels as a clinical pre-test probability assessment for predicting PE in patients ‘at...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-09-01
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| Series: | Journal of Family Medicine and Primary Care |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/jfmpc.jfmpc_2455_22 |
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| _version_ | 1846170814685118464 |
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| author | Sweety Singh Atul Goel |
| author_facet | Sweety Singh Atul Goel |
| author_sort | Sweety Singh |
| collection | DOAJ |
| description | Aims:
Pulmonary embolism (PE) is the most severe complication of deep venous thrombosis (DVT). This study was designed to evaluate the usefulness of modified Wells score combined with age-adjusted D-dimer cut-off levels as a clinical pre-test probability assessment for predicting PE in patients ‘at risk for DVT.’
Methods:
This was a cross-sectional study including 200 in-patients at risk for DVT. Patients were categorized as ‘pulmonary embolism unlikely’ or ‘pulmonary embolism likely’ using modified Wells score and underwent D-dimer testing. PE was considered excluded in patients classified as unlikely with normal D-dimer levels, whereas the rest of the patients underwent computed tomography pulmonary angiogram (CTPA).
Results:
Out of 200 patients, 163 patients (81.50%) were ‘pulmonary embolism unlikely,’ whereas 37 patients (18.50%) were ‘pulmonary embolism likely.’ Of 163 patients categorized as ‘pulmonary embolism unlikely,’ 67 patients (41.5%) had normal D-dimer values and were excluded from CTPA. PE was detected in 24.2% of the patients who underwent CTPA.
Conclusion:
The combined strategy using modified Wells score and age-adjusted D-dimer cut-off value has 100% sensitivity and a negative predictive value and can be used to safely exclude PE in in-patients. |
| format | Article |
| id | doaj-art-3f62b12fc6804980967d3d03f0e74c9d |
| institution | Kabale University |
| issn | 2249-4863 2278-7135 |
| language | English |
| publishDate | 2023-09-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Family Medicine and Primary Care |
| spelling | doaj-art-3f62b12fc6804980967d3d03f0e74c9d2024-11-11T11:10:57ZengWolters Kluwer Medknow PublicationsJournal of Family Medicine and Primary Care2249-48632278-71352023-09-011292020202310.4103/jfmpc.jfmpc_2455_22A study of modified Wells score for pulmonary embolism and age-adjusted D-dimer values in patients at risk for deep venous thrombosisSweety SinghAtul GoelAims: Pulmonary embolism (PE) is the most severe complication of deep venous thrombosis (DVT). This study was designed to evaluate the usefulness of modified Wells score combined with age-adjusted D-dimer cut-off levels as a clinical pre-test probability assessment for predicting PE in patients ‘at risk for DVT.’ Methods: This was a cross-sectional study including 200 in-patients at risk for DVT. Patients were categorized as ‘pulmonary embolism unlikely’ or ‘pulmonary embolism likely’ using modified Wells score and underwent D-dimer testing. PE was considered excluded in patients classified as unlikely with normal D-dimer levels, whereas the rest of the patients underwent computed tomography pulmonary angiogram (CTPA). Results: Out of 200 patients, 163 patients (81.50%) were ‘pulmonary embolism unlikely,’ whereas 37 patients (18.50%) were ‘pulmonary embolism likely.’ Of 163 patients categorized as ‘pulmonary embolism unlikely,’ 67 patients (41.5%) had normal D-dimer values and were excluded from CTPA. PE was detected in 24.2% of the patients who underwent CTPA. Conclusion: The combined strategy using modified Wells score and age-adjusted D-dimer cut-off value has 100% sensitivity and a negative predictive value and can be used to safely exclude PE in in-patients.https://journals.lww.com/10.4103/jfmpc.jfmpc_2455_22deep venous thrombosisd-dimerpulmonary embolismwells score |
| spellingShingle | Sweety Singh Atul Goel A study of modified Wells score for pulmonary embolism and age-adjusted D-dimer values in patients at risk for deep venous thrombosis Journal of Family Medicine and Primary Care deep venous thrombosis d-dimer pulmonary embolism wells score |
| title | A study of modified Wells score for pulmonary embolism and age-adjusted D-dimer values in patients at risk for deep venous thrombosis |
| title_full | A study of modified Wells score for pulmonary embolism and age-adjusted D-dimer values in patients at risk for deep venous thrombosis |
| title_fullStr | A study of modified Wells score for pulmonary embolism and age-adjusted D-dimer values in patients at risk for deep venous thrombosis |
| title_full_unstemmed | A study of modified Wells score for pulmonary embolism and age-adjusted D-dimer values in patients at risk for deep venous thrombosis |
| title_short | A study of modified Wells score for pulmonary embolism and age-adjusted D-dimer values in patients at risk for deep venous thrombosis |
| title_sort | study of modified wells score for pulmonary embolism and age adjusted d dimer values in patients at risk for deep venous thrombosis |
| topic | deep venous thrombosis d-dimer pulmonary embolism wells score |
| url | https://journals.lww.com/10.4103/jfmpc.jfmpc_2455_22 |
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