Diagnosis of pulmonary embolism in patients with acute exacerbations of chronic obstructive pulmonary disease: a cross-sectional study

Autores
Maritano Furcada, Joaquín; Castro, Horacio Matías; de Vito, Eduardo; Grande Ratti, María Florencia; Posadas Martinez, Maria Lourdes; Giunta, Diego Hernan; Vazquez, Fernando Javier; Ferreyro, Bruno Leonel
Año de publicación
2020
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Introduction: Pulmonary embolism (PE) remains a frequent complication in patients with chronic obstructive pulmonary disease (COPD). It is unclear that the extent to which the traditional risk stratifying scores for PE are accurate in this population. Methods: Cross-sectional study of adult patients with COPD and suspected PE included in an Institutional Registry of Thromboembolic Disease at a tertiary teaching hospital in the city of Buenos Aires, Argentina. We estimated the area under the receiver operating characteristic curves (AU-ROC), sensitivity and specificity of the Wells and Geneva scores using a positive computed tomography angiography as the gold standard for PE. We also estimated the sensitivity and specificity for the presence of isolated worsening of dyspnea at presentation, without other cardinal symptoms of acute exacerbation of COPD. Results: A total of 168 patients were included, of which 22% had confirmed PE. The AUC was 0.66 (95% CI 0.56-0.76) and 0.56 (95% CI 0.45-0.67) for the Wells and Geneva, respectively. Considering the most widely used cutoff points, the sensitivity and specificity were 24% and 90% for the Wells and 59% and 43% for the Geneva score, respectively. Isolated worsening of dyspnea on presentation had a sensitivity of 92% and specificity of 37%. Conclusions: Both Wells and Geneva scores exhibit poor diagnostic accuracy for the diagnosis of PE in patients with COPD. The presence of isolated worsening of dyspnea on presentation could be an easy to identify criteria for the initial triage in this population. Further validation of our findings remains warranted.
Fil: Maritano Furcada, Joaquín. Hospital Italiano; Argentina
Fil: Castro, Horacio Matías. Hospital Italiano; Argentina
Fil: de Vito, Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina
Fil: Grande Ratti, María Florencia. Hospital Italiano; Argentina
Fil: Posadas Martinez, Maria Lourdes. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Hospital Italiano; Argentina
Fil: Giunta, Diego Hernan. Hospital Italiano; Argentina
Fil: Vazquez, Fernando Javier. Hospital Italiano; Argentina
Fil: Ferreyro, Bruno Leonel. Hospital Italiano; Argentina. University of Toronto; Canadá
Materia
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
PULMONARY EMBOLISM
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/170498
Acceder
id CONICETDig_7ba16ae56c39ce53b5ed64f604c8305d
oai_identifier_str oai:ri.conicet.gov.ar:11336/170498
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Diagnosis of pulmonary embolism in patients with acute exacerbations of chronic obstructive pulmonary disease: a cross-sectional studyMaritano Furcada, JoaquínCastro, Horacio Matíasde Vito, EduardoGrande Ratti, María FlorenciaPosadas Martinez, Maria LourdesGiunta, Diego HernanVazquez, Fernando JavierFerreyro, Bruno LeonelCHRONIC OBSTRUCTIVE PULMONARY DISEASEPULMONARY EMBOLISMhttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Introduction: Pulmonary embolism (PE) remains a frequent complication in patients with chronic obstructive pulmonary disease (COPD). It is unclear that the extent to which the traditional risk stratifying scores for PE are accurate in this population. Methods: Cross-sectional study of adult patients with COPD and suspected PE included in an Institutional Registry of Thromboembolic Disease at a tertiary teaching hospital in the city of Buenos Aires, Argentina. We estimated the area under the receiver operating characteristic curves (AU-ROC), sensitivity and specificity of the Wells and Geneva scores using a positive computed tomography angiography as the gold standard for PE. We also estimated the sensitivity and specificity for the presence of isolated worsening of dyspnea at presentation, without other cardinal symptoms of acute exacerbation of COPD. Results: A total of 168 patients were included, of which 22% had confirmed PE. The AUC was 0.66 (95% CI 0.56-0.76) and 0.56 (95% CI 0.45-0.67) for the Wells and Geneva, respectively. Considering the most widely used cutoff points, the sensitivity and specificity were 24% and 90% for the Wells and 59% and 43% for the Geneva score, respectively. Isolated worsening of dyspnea on presentation had a sensitivity of 92% and specificity of 37%. Conclusions: Both Wells and Geneva scores exhibit poor diagnostic accuracy for the diagnosis of PE in patients with COPD. The presence of isolated worsening of dyspnea on presentation could be an easy to identify criteria for the initial triage in this population. Further validation of our findings remains warranted.Fil: Maritano Furcada, Joaquín. Hospital Italiano; ArgentinaFil: Castro, Horacio Matías. Hospital Italiano; ArgentinaFil: de Vito, Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; ArgentinaFil: Grande Ratti, María Florencia. Hospital Italiano; ArgentinaFil: Posadas Martinez, Maria Lourdes. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Hospital Italiano; ArgentinaFil: Giunta, Diego Hernan. Hospital Italiano; ArgentinaFil: Vazquez, Fernando Javier. Hospital Italiano; ArgentinaFil: Ferreyro, Bruno Leonel. Hospital Italiano; Argentina. University of Toronto; CanadáWiley Blackwell Publishing, Inc2020-12info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/170498Maritano Furcada, Joaquín; Castro, Horacio Matías; de Vito, Eduardo; Grande Ratti, María Florencia; Posadas Martinez, Maria Lourdes; et al.; Diagnosis of pulmonary embolism in patients with acute exacerbations of chronic obstructive pulmonary disease: a cross-sectional study; Wiley Blackwell Publishing, Inc; Clinical Respiratory Journal; 14; 12; 12-2020; 1-171752-6981CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://onlinelibrary.wiley.com/doi/abs/10.1111/crj.13257info:eu-repo/semantics/altIdentifier/doi/10.1111/crj.13257info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T10:13:36Zoai:ri.conicet.gov.ar:11336/170498instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 10:13:37.047CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Diagnosis of pulmonary embolism in patients with acute exacerbations of chronic obstructive pulmonary disease: a cross-sectional study
title Diagnosis of pulmonary embolism in patients with acute exacerbations of chronic obstructive pulmonary disease: a cross-sectional study
spellingShingle Diagnosis of pulmonary embolism in patients with acute exacerbations of chronic obstructive pulmonary disease: a cross-sectional study
Maritano Furcada, Joaquín
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
PULMONARY EMBOLISM
title_short Diagnosis of pulmonary embolism in patients with acute exacerbations of chronic obstructive pulmonary disease: a cross-sectional study
title_full Diagnosis of pulmonary embolism in patients with acute exacerbations of chronic obstructive pulmonary disease: a cross-sectional study
title_fullStr Diagnosis of pulmonary embolism in patients with acute exacerbations of chronic obstructive pulmonary disease: a cross-sectional study
title_full_unstemmed Diagnosis of pulmonary embolism in patients with acute exacerbations of chronic obstructive pulmonary disease: a cross-sectional study
title_sort Diagnosis of pulmonary embolism in patients with acute exacerbations of chronic obstructive pulmonary disease: a cross-sectional study
dc.creator.none.fl_str_mv Maritano Furcada, Joaquín
Castro, Horacio Matías
de Vito, Eduardo
Grande Ratti, María Florencia
Posadas Martinez, Maria Lourdes
Giunta, Diego Hernan
Vazquez, Fernando Javier
Ferreyro, Bruno Leonel
author Maritano Furcada, Joaquín
author_facet Maritano Furcada, Joaquín
Castro, Horacio Matías
de Vito, Eduardo
Grande Ratti, María Florencia
Posadas Martinez, Maria Lourdes
Giunta, Diego Hernan
Vazquez, Fernando Javier
Ferreyro, Bruno Leonel
author_role author
author2 Castro, Horacio Matías
de Vito, Eduardo
Grande Ratti, María Florencia
Posadas Martinez, Maria Lourdes
Giunta, Diego Hernan
Vazquez, Fernando Javier
Ferreyro, Bruno Leonel
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv CHRONIC OBSTRUCTIVE PULMONARY DISEASE
PULMONARY EMBOLISM
topic CHRONIC OBSTRUCTIVE PULMONARY DISEASE
PULMONARY EMBOLISM
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Introduction: Pulmonary embolism (PE) remains a frequent complication in patients with chronic obstructive pulmonary disease (COPD). It is unclear that the extent to which the traditional risk stratifying scores for PE are accurate in this population. Methods: Cross-sectional study of adult patients with COPD and suspected PE included in an Institutional Registry of Thromboembolic Disease at a tertiary teaching hospital in the city of Buenos Aires, Argentina. We estimated the area under the receiver operating characteristic curves (AU-ROC), sensitivity and specificity of the Wells and Geneva scores using a positive computed tomography angiography as the gold standard for PE. We also estimated the sensitivity and specificity for the presence of isolated worsening of dyspnea at presentation, without other cardinal symptoms of acute exacerbation of COPD. Results: A total of 168 patients were included, of which 22% had confirmed PE. The AUC was 0.66 (95% CI 0.56-0.76) and 0.56 (95% CI 0.45-0.67) for the Wells and Geneva, respectively. Considering the most widely used cutoff points, the sensitivity and specificity were 24% and 90% for the Wells and 59% and 43% for the Geneva score, respectively. Isolated worsening of dyspnea on presentation had a sensitivity of 92% and specificity of 37%. Conclusions: Both Wells and Geneva scores exhibit poor diagnostic accuracy for the diagnosis of PE in patients with COPD. The presence of isolated worsening of dyspnea on presentation could be an easy to identify criteria for the initial triage in this population. Further validation of our findings remains warranted.
Fil: Maritano Furcada, Joaquín. Hospital Italiano; Argentina
Fil: Castro, Horacio Matías. Hospital Italiano; Argentina
Fil: de Vito, Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina
Fil: Grande Ratti, María Florencia. Hospital Italiano; Argentina
Fil: Posadas Martinez, Maria Lourdes. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Hospital Italiano; Argentina
Fil: Giunta, Diego Hernan. Hospital Italiano; Argentina
Fil: Vazquez, Fernando Javier. Hospital Italiano; Argentina
Fil: Ferreyro, Bruno Leonel. Hospital Italiano; Argentina. University of Toronto; Canadá
description Introduction: Pulmonary embolism (PE) remains a frequent complication in patients with chronic obstructive pulmonary disease (COPD). It is unclear that the extent to which the traditional risk stratifying scores for PE are accurate in this population. Methods: Cross-sectional study of adult patients with COPD and suspected PE included in an Institutional Registry of Thromboembolic Disease at a tertiary teaching hospital in the city of Buenos Aires, Argentina. We estimated the area under the receiver operating characteristic curves (AU-ROC), sensitivity and specificity of the Wells and Geneva scores using a positive computed tomography angiography as the gold standard for PE. We also estimated the sensitivity and specificity for the presence of isolated worsening of dyspnea at presentation, without other cardinal symptoms of acute exacerbation of COPD. Results: A total of 168 patients were included, of which 22% had confirmed PE. The AUC was 0.66 (95% CI 0.56-0.76) and 0.56 (95% CI 0.45-0.67) for the Wells and Geneva, respectively. Considering the most widely used cutoff points, the sensitivity and specificity were 24% and 90% for the Wells and 59% and 43% for the Geneva score, respectively. Isolated worsening of dyspnea on presentation had a sensitivity of 92% and specificity of 37%. Conclusions: Both Wells and Geneva scores exhibit poor diagnostic accuracy for the diagnosis of PE in patients with COPD. The presence of isolated worsening of dyspnea on presentation could be an easy to identify criteria for the initial triage in this population. Further validation of our findings remains warranted.
publishDate 2020
dc.date.none.fl_str_mv 2020-12
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/170498
Maritano Furcada, Joaquín; Castro, Horacio Matías; de Vito, Eduardo; Grande Ratti, María Florencia; Posadas Martinez, Maria Lourdes; et al.; Diagnosis of pulmonary embolism in patients with acute exacerbations of chronic obstructive pulmonary disease: a cross-sectional study; Wiley Blackwell Publishing, Inc; Clinical Respiratory Journal; 14; 12; 12-2020; 1-17
1752-6981
CONICET Digital
CONICET
url http://hdl.handle.net/11336/170498
identifier_str_mv Maritano Furcada, Joaquín; Castro, Horacio Matías; de Vito, Eduardo; Grande Ratti, María Florencia; Posadas Martinez, Maria Lourdes; et al.; Diagnosis of pulmonary embolism in patients with acute exacerbations of chronic obstructive pulmonary disease: a cross-sectional study; Wiley Blackwell Publishing, Inc; Clinical Respiratory Journal; 14; 12; 12-2020; 1-17
1752-6981
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://onlinelibrary.wiley.com/doi/abs/10.1111/crj.13257
info:eu-repo/semantics/altIdentifier/doi/10.1111/crj.13257
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Wiley Blackwell Publishing, Inc
publisher.none.fl_str_mv Wiley Blackwell Publishing, Inc
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.070432

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