Prediction Scores Do Not Correlate with Clinically Adjudicated Categories of Pulmonary Embolism in Critically Ill Patients

Katsios, Christina M.; Donadini, Marco Paolo; Meade, Maureen O.; Mehta, Sangeeta; Hall, Richard; Granton, John; Kutsiogiannis, Jim; Dodek, Peter; Heels‐Ansdell, Diane; McIntyre, Lauralyn; Vlahakis, Nicholas E.; Muscedere, John; Friedrich, Jan O.; Fowler, Robert; Skrobik, Yoanna; Albert, Martin; Cox, Michael J.; Klinger, James R.; Nates, Joseph L.; Bersten, Andrew D.; Doig, Christopher J.; Zytaruk, Nicole; Crowther, Mark; Cook, Deborah J.

doi:10.1155/2014/296161

Cited by 11 publications

(10 citation statements)

References 28 publications

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“…In agreement with our results, in a cohort of 70 patients, Katsios et al showed that pretest probability models developed for outpatients do not correlate with clinically suspected PE in critically ill patients. 22,27 Interestingly, as described by Bahloul et al, 28 few patients with confirmed PE have high probability by Wells and Geneva scores compared to previous studies mainly in noncritically ill patients. 8,29 It is possible that in ICU patients, the factors associated with high clinical pretest probability might be different than the factors included in composite scores.…”

Section: Discussionmentioning

confidence: 86%

Wells and Geneva Scores Are Not Reliable Predictors of Pulmonary Embolism in Critically Ill Patients: A Retrospective Study

Girardi

Bettiol

Garcia

et al. 2018

J Intensive Care Med

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Background: Critically ill patients are at high risk for pulmonary embolism (PE). Specific PE prediction rules have not been validated in this population. The present study assessed the Wells and revised Geneva scoring systems as predictors of PE in critically ill patients. Methods: Pulmonary computed tomographic angiograms (CTAs) performed for suspected PE in critically ill adult patients were retrospectively identified. Wells and revised Geneva scores were calculated based on information from medical records. The reliability of both scores as predictors of PE was determined using receiver operating characteristic (ROC) curve analysis. Results: Of 138 patients, 42 (30.4%) were positive for PE based on pulmonary CTA. Mean Wells score was 4.3 (3.5) in patients with PE versus 2.7 (1.9) in patients without PE ( P < .001). Revised Geneva score was 5.8 (3.3) versus 5.1 (2.5) in patients with versus without PE ( P = .194). According to the Wells and revised Geneva scores, 56 (40.6%) patients and 49 (35.5%) patients, respectively, were considered as low probability for PE. Of those considered as low risk by the Wells score, 15 (26.8%) had filling defects on CTA, including 2 patients with main pulmonary artery embolism. The area under the ROC curve was 0.634 for the Wells score and 0.546 for the revised Geneva score. Wells score >4 had a sensitivity of 40%, specificity of 87%, positive predictive value of 59%, and negative predictive value of 77% to predict risk of PE. Conclusions: In this population of critically ill patients, Wells and revised Geneva scores were not reliable predictors of PE.

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Section: Discussionmentioning

confidence: 86%

Wells and Geneva Scores Are Not Reliable Predictors of Pulmonary Embolism in Critically Ill Patients: A Retrospective Study

Girardi

Bettiol

Garcia

et al. 2018

J Intensive Care Med

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“…This finding had already been suggested for patients in critical condition in several clinical trials. (19)(20)(21) Two studies evaluating this aspect in patients hospitalized for COVID-19 infection undergoing CTPA found that the Wells and Geneva scores showed no predictive value for the occurrence of PE, either considering a standard or age-adjusted cutoff point. (22,23) There were no cases of mortality in the group of patients with COVID-19 infection in whom PE was diagnosed, a result that could be attributed to the identification of milder cases (lower PESI) after a more careful diagnostic evaluation in this population.…”

Section: Discussionmentioning

confidence: 99%

Clinical, Diagnostic and Prognostic Characterization of Patients with Suspected Pulmonary Embolism Before and During COVID-19

Aponte¹,

Taboada²,

Fierro³

et al. 2022

Rev Argent Cardiol

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“…Diagnosing PE is often challenging because the signs and symptoms are not specific [14]. There are various scoring systems that determine whether a patient is more or less likely to have a PE.…”

Section: Discussionmentioning

confidence: 99%

Effect of Beta-blockers on Tachycardia in Patients with Pulmonary Embolism

Aslam

Naeem

Prabhakar

et al. 2019

Cureus

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Prediction Scores Do Not Correlate with Clinically Adjudicated Categories of Pulmonary Embolism in Critically Ill Patients

Abstract: Pretest probability scores developed outside the ICU do not correlate with adjudicated PE categories in critically ill patients. Research is needed to develop prediction scores for this population.

Cited by 11 publications

References 28 publications

Wells and Geneva Scores Are Not Reliable Predictors of Pulmonary Embolism in Critically Ill Patients: A Retrospective Study

Wells and Geneva Scores Are Not Reliable Predictors of Pulmonary Embolism in Critically Ill Patients: A Retrospective Study

Clinical, Diagnostic and Prognostic Characterization of Patients with Suspected Pulmonary Embolism Before and During COVID-19

Effect of Beta-blockers on Tachycardia in Patients with Pulmonary Embolism

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