Professional paper
https://doi.org/10.20471/acc.2022.61.s1.05
Diagnosis of pulmonary embolism in the Emergency Department
Damir Rošić
; Institute of Emergency Medicine of Primorje – Gorski Kotar County, The Medical School of the Catholic University of Croatia
Nikola Kočet
; Institute of Emergency Medicine of Varaždin County
Anđela Simić
; Institute of Emergency Medicine of Varaždin County
Ingrid Prkačin
; Emergency Department University Hospital Merkur, School of Medicine University of Zagreb
Višnja Nesek Adam
; Emergency Department Clinical Hospital Sveti Duh, School of Medicine J.J. Strossmayer University of Osijek
Abstract
The aim of this study was to determine the association of clinical presentation, the
Wells scoring system and D-dimer values with MSCT pulmonary angiography. A case control study
was conducted in the Emergency Department of the Clinical Hospital Sveti Duh throughout 2019.
Patients with a referral diagnosis of a pulmonary embolism were included in the study. Patients were
divided into two groups. The first group consisted of patients diagnosed with pulmonary embolism by
MSCT pulmonary angiography or postmortem, and the second group consisted of patients excluded
from pulmonary embolisms. For the Wells score, D-dimers, troponin, respiratory rate and peripheral
blood oxygen saturation, statistically significant differences were found between groups of patients
with confirmed or excluded pulmonary embolism (p <0.001). For heart rate, chest pain, syncope, and
hemoptysis, no statistically significant differences were found between these two groups of patients.
Deep venous thrombosis of the lower extremities was found by ultrasound in > 70% of patients with
massive a pulmonary embolism. Pulmonary embolism was confirmed in all patients for whom a high
risk was calculated according to the Wells score. In conclusion, a low degree of clinical probability
(according to the Wells score), along with a normal concentration of D-dimer, are a sure strategy in
excluding pulmonary embolism.
Keywords
pulmonary embolism; Wells score; D-dimers; MSCT pulmonary angiography; emergency medical service
Hrčak ID:
281169
URI
Publication date:
1.6.2022.
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