Aplicación de la Escala de Wells ante Tromboembolismo Pulmonar Agudo en el Servicio de Urgencias. Resultados Preliminares de un Estudio Observacional

  1. Láinez Ramos-Bossini A. J.
  2. Gálvez-López R.
  3. Moreno-Suárez S.
  4. Rivera-Izquierdo M.
Zeitschrift:
Actualidad médica

ISSN: 0365-7965

Datum der Publikation: 2018

Band: 103

Nummer: 805

Seiten: 130-135

Art: Artikel

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Andere Publikationen in: Actualidad médica

Zusammenfassung

Objectives: To study the frequency of use and assess potential factors associated to the use of Diagnostic Probability Scales (Wells’ Criteria) in suspected acute Pulmonary Embolism (PE) in patients that were tested using computarized tomography angiography (CTA) or ventilation/perfusion scintigraphy (V/Q scan). Methods: A retrospective observational study was conducted through the examination of clinical histories of patients admitted to the ED in our hospital that underwent CTA or V/Q scans due to suspected PE. Sociodemographic factors, Wells’ score, D-dimer values, PE prevalence, symptoms, risk factors, alternative diagnoses and retrospective simplified Wells’ scores were obtained. Frequency and association analyses were conducted. Results: Sixty-two patients (38.18% males) were included, of which nineteen (29.69%) presented PE. The most common alternative diagnoses were heart failure and respiratory infections. Wells score appeared in only 2 cases (3.13%). Retrospective simplified Wells score showed that 50 patients (78.13%) had low probability and 14 patients (21.88%) had high probability of PE. When stratified by presence of PE, significant differences were found between low and high probability groups (p = .008). In the latter group, the protocol was correctly followed in only 1 patient (6.67%). No significant differences were found between the PE versus no PE groups regarding symptoms, risk factors, age or gender. Conclusion: The low use of PSS found implies bad adherence to clinical protocols in suspected PE. The prevalence, symptoms and risk factors associated with PE found in this study are similar to those reported in the literature, with some exceptions that should be confirmed in future studies.

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