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Clinical Signs and Symptoms in Pulmonary Embolism A Reassessment
- Source :
- Clinical Nuclear Medicine. 19:803-808
- Publication Year :
- 1994
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 1994.
-
Abstract
- The clinical diagnosis of pulmonary embolism (PE) remains difficult despite years of investigation. The clinical signs and symptoms of pulmonary embolism are numerous, but they are not diagnostically accurate. Radionuclide ventilation perfusion imaging (VQ) has become an important adjunct in screening patients for suspected PE. This study re-evaluates the predictive capabilities of various clinical signs and symptoms in a population of patients in whom angiography was thought to be necessary because of clinical concern for PE. One hundred one patients with suspected PE were retrospectively identified. Clinical information on them was complete, and laboratory studies, VQ imaging, and pulmonary angiography were performed. Thirty-seven clinical signs, symptoms, and other characteristics were individually compared for patients whose angiographic results were positive or negative for PE. Modifying or interactive effects on PE were then examined with logistic regression analysis. Several clinical conditions, including immobilization and recent surgery, were significantly associated with PE. Shortness of breath and history of smoking were significantly associated with negative results on pulmonary angiography. A "high probability" VQ scan was highly predictive (P.0001) of positive results on angiography. When interactive factors for PE were examined, lack of shortness of breath and arterial pHor = 7.45, lack of shortness of breath and respiratory rate23, diaphoresis in a nonsmoker and immobilized female, were significantly associated with PE. This study again documents the difficulty in using clinical criteria--including signs, symptoms, and laboratory determinations--to predict PE accurately, even in a population in which PE was of clinical concern irrespective of the VQ scan results.(ABSTRACT TRUNCATED AT 250 WORDS)
- Subjects :
- Male
medicine.medical_specialty
Population
Sweating
Sensitivity and Specificity
Ventilation/perfusion ratio
Immobilization
Risk Factors
Ventilation-Perfusion Ratio
medicine
Pulmonary angiography
Humans
Radiology, Nuclear Medicine and imaging
Radionuclide Imaging
education
Technetium Tc 99m Aggregated Albumin
Retrospective Studies
education.field_of_study
Lung
medicine.diagnostic_test
business.industry
Respiration
Smoking
Respiratory disease
Angiography
Retrospective cohort study
General Medicine
Middle Aged
medicine.disease
Pulmonary embolism
Dyspnea
medicine.anatomical_structure
Surgical Procedures, Operative
Regression Analysis
Technetium Tc 99m Pentetate
Female
Radiology
Pulmonary Embolism
business
Forecasting
Subjects
Details
- ISSN :
- 03639762
- Volume :
- 19
- Database :
- OpenAIRE
- Journal :
- Clinical Nuclear Medicine
- Accession number :
- edsair.doi.dedup.....50a3f7a55648aa0ddba3151d570e3cf5