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COMPARISON OF THREE CLINICAL SCORING METHODS IN PATIENTS WITH PULMONARY THROMBOEMBOLISM

COMPARISON OF THREE CLINICAL SCORING METHODS IN PATIENTS WITH PULMONARY THROMBOEMBOLISM. ,. Rabia Unver 1 , Gülfer Okumus 1 , Esen Kıyan 1 , Levent Tabak 1 , Halim Issever 2 , Orhan Arseven 1 Istanbul University Istanbul Medical Faculty, Department of 1 Chest Diseases ,

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COMPARISON OF THREE CLINICAL SCORING METHODS IN PATIENTS WITH PULMONARY THROMBOEMBOLISM

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  1. COMPARISON OF THREE CLINICAL SCORING METHODS IN PATIENTS WITH PULMONARYTHROMBOEMBOLISM , Rabia Unver1, Gülfer Okumus1, Esen Kıyan1, Levent Tabak1, Halim Issever2, Orhan Arseven1 Istanbul University Istanbul Medical Faculty, Department of 1Chest Diseases, 2Public Health, Istanbul, Turkey

  2. The clinical diagnosis is not reliable in pulmonary thromboembolism (PTE) because the symptoms are mostly nonspecific. • It has been shown that clinical scoring consisting risk factors can be valuable in patients with high probability.

  3. Different prediction rules for PTE have been descriebed recently.

  4. WELLS < 2 Low probability 2-6 Intermediate >6 High probability

  5. WICKI 0-4 Low probability 5-8 Intermediate 9 High probability

  6. HYERS Hyers TH. Thorax 1995;50:930-2

  7. In those suggested methods the analysis of the arterial blood gas analysis and radiologic findings are necessary to evaluate as much as the clinical findings. • It is hard to keep in mind the scoring points.

  8. HYERS (adapted)

  9. AIM • To determine the correlation of the clinical probabilities according to the Wicki rule, Wells rule and adapted Hyers rule in patients with PTE.

  10. MATERIAL and METHODS • Clinical probabilities of patients with PTE, which are diagnosed objectively in past six years, were determined with Wells, Wicki and adapted Hyers rules.

  11. 119 Male, 129 Female • Mean age: 57 ± 16.7 (16-91) • Cases were evaluated retrospectively with Wicki, Wells and adapted form of Hyers rules.

  12. Statistical analysis:(Correlation tests) • Cramer’s, • Contengency Coefficient(CC), • Spearman’s Rho, • Kendall’s Tau-b, • Kappa tests

  13. Age>40 Obesity DVT history Immobilization Travel Pregnancy Heart Failure COPD Stroke Nephrotic syndrome Oral contraceptives Surgery Trauma Malignency Infection Burn Risk factors

  14. RESULTS-1

  15. RESULTS-2

  16. Hyers rules are found to be more meaningful compared to other scoring methods. • There was the best correlance between Wells and adapted Hyers rules.

  17. CONCLUSION • Adapted Hyers rule which is only based on risk factors and symptoms is found as valuable as the other scoring systems using blood gases and radiological findings.

  18. Although most of the centers, all around the world have diagnosis and treatment algoritm specified for country conditions, hospital possibilities and patients, there is not a guideline in our country yet. G.Okumuş, E.yalnız, B.Msellim, G.Çelik, S.Aktoğu, Ö.Özdemir, L.Tabak, G.Öngen Clinical Problems Operative Council of Turkish Thoracic Society

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