TITLE

Comparison of new clinical and scintigraphic algorithms for the diagnosis of pulmonary embolism

AUTHOR(S)
McLean R G; Carolan M; Bui C; Arvela O; Ford J C; Chew M; Wadhwa S; Elison B S
PUB. DATE
May 2004
SOURCE
British Journal of Radiology;May2004, Vol. 77 Issue 917, p372
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Since the publication of the modified Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) criteria for the diagnosis of pulmonary embolism (PE), new clinical and scintigraphic diagnostic algorithms (the McMaster clinical criteria, the PisaPED simplified scintigraphic grading and the Miettinen logistic regression analysis) have been reported although the results have not been reproduced in other sites. Ventilation-perfusion lung scintigraphy was performed in 238 consecutive patients with a provisional diagnosis of PE. Scans were reported as normal/very low, low, intermediate or high probability for PE using standardized criteria. Each patient received a clinical grading of probability of PE as low, moderate or high using the McMaster clinical criteria. Using the PisaPED criteria (an alternate simplified scintigraphic grading system using the perfusion scan alone) each scan was also graded as normal/near normal, abnormal but not PE, or abnormal and PE. Using the logistic regression algorithm of Miettinen each scan received a numerical probability of PE. Frequencies for differing levels of probability of PE varied widely between the various algorithms. Cross tabulations revealed correlation of the standardized criteria with the Miettinen grading but not with the McMaster or the PisaPED gradings. We were unable to reproduce similar results using the McMaster clinical grading or the PisaPED simplified scintigraphic grading although the Miettinen logistic regression formula gave comparable results. New algorithms are not automatically transferable to new environments.
ACCESSION #
14593981

 

Related Articles

  • Lessons from Surgical Embolectomy for Saddle Pulmonary Embolism: A Case Report and Literature Review. Williams, Eric W.; Cawich, Shamir o.; Irvine, Roger; Shah, Sundeep; Williams-Johnson, Jean; Blake, Garfield; Singh, Praim; Hall, Nadia; Espinosa, Kurdell; French, Simone // Internet Journal of Thoracic & Cardiovascular Surgery;2007, Vol. 10 Issue 1, p2 

    Saddle emboli are one of the most severe forms of Pulmonary Embolism and are associated with high mortality rates. Patient salvage depends upon making an early diagnosis, although there is still much controversy regarding the ideal therapeutic strategy for confirmed cases. We present a case...

  • Commentary: A simple prediction rule identified patients with pulmonary embolism at low risk of short term death. O'Flaherty, Martin; Gandara, Esteban // Evidence Based Medicine;Aug2006, Vol. 11 Issue 4, p121 

    The article reflects on the Aujesky rule which has identified patients with pulmonary embolism at low risk of short term death. It argues that the Aujesky rule is an accurate risk prediction tool which is useful in a wide range of settings and is a promising therapeutic decision aid. It compares...

  • Meta-Analysis: Outcomes in Patients with Suspected Pulmonary Embolism Managed with Computed Tomographic Pulmonary Angiography. Clagett, G. Patrick // Perspectives in Vascular Surgery & Endovascular Therapy;Sep2005, Vol. 17 Issue 3, p271 

    The authors conducted at study to assess the safety of withholding anticoagulation in patients with a suspected pulmonary embolism and negative results on computed tomographic pulmonary angiography (CTPA). CTPA is being increasingly used in the evaluation of patients with suspected PE, but it...

  • Delayed intracardial shunting and hypoxemia after massive pulmonary embolism in a patient with a biventricular assist device.  // Journal of Cardiothoracic Surgery;2011, Vol. 6 Issue 1, p133 

    The article presents the case of a 34 year old female patient with delayed intracardial shunting and hypoxemia after massive pulmonary embolism with a biventricular assist device (BVAD). Emergency surgical embolectomy for massive pulmonary embolism was performed. Heart transplantation was...

  • Khat Chewing: A Smokeless Gun? Mateen, Farrah J.; Cascino, Gregory D. // Mayo Clinic Proceedings;Nov2010, Vol. 85 Issue 11, p971 

    The authors comment on a study regarding the prevalence of khat chewing, which was associated with increased risk of stroke and death. Patients from Eastern African and Yemeni origins were evaluated and counseled about khat chewing when they are living in Western countries. The authors highlight...

  • Emergent Surgery for Massive Pulmonary Embolism. Brevetti, Gregory B.; O'Brien, Benjamin; Coomer, Cynara L.; Hall, Timothy S; Brevetti, Lucy S.; Jablons, David M. // Texas Heart Institute Journal;2003, Vol. 30 Issue 2, p149 

    We treated a 52 year-old man for a large pleura/effusion that had occurred after he fell from a ladder. Upon discharge from the hospital the patient collapsed and was nonresponsive and hypotensive. We suspected the cause to be pulmonary embolism. When it became evident that this patient would...

  • Aggressive Approach to Pulmonary Embolectomy for Massive Acute Pulmonary Embolism: A Historical and Contemporary Perspective. McFadden, P. Michael; Ochsner, John L. // Mayo Clinic Proceedings;Sep2010, Vol. 85 Issue 9, p782 

    The author reflects on the surgical treatment for acute pulmonary embolism (PE). He notes that the surgical techniques used for PE is a variation of modified Trendelenburg procedure used by many surgeons. An overview of the approach to treat surgical PE and its resurgence of interest is...

  • Acute pulmonary embolism revisited. Konstantinides, Stavros V // Heart;Jun2008, Vol. 94 Issue 6, p795 

    The article discusses the acute pulmonary embolism and the diagnostic modalities in treating patients with pulmonary embolism. It explains acute right ventricular dysfunction and the presence or absence of haemodynamic instability that determines the diagnostic and therapeutic approach to a...

  • ANGIOGRAPHIC DEMONSTRATION OF ACUTE PULMONARY EMBOLI. Melnick, Gilbert S. // Angiology;Oct1963, Vol. 14 Issue 10, p491 

    A case was reported of a 76-year-old man whose clinical picture strongly indicated acute pulmonary embolism. A venous angiocardiogram, performed as an emergency procedure, confirmed bilateral, central pulmonary emboli. Successful removal was performed under cardiopulmonary bypass, but the...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics