PULMONARY ARTERY THROMBOEMBOLISM: FACTORS OF PREHOSPITAL OVERDIAGNOSIS
Aim. Detection and analysis of factors of pulmonary artery thromboembolism (PATE) overdiagnosis in a prehospital setting. Material and methods. A total of 102 patients with prehospital diagnosis of PATE entered the study. Prehospital clinical and ECG picture was compared in groups of verified PATE (...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | Russian |
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"Consilium Medicum" Publishing house
2012-04-01
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| Series: | Терапевтический архив |
| Subjects: | |
| Online Access: | https://ter-arkhiv.ru/0040-3660/article/view/31004 |
| Summary: | Aim. Detection and analysis of factors of pulmonary artery thromboembolism (PATE) overdiagnosis in a prehospital setting. Material and methods. A total of 102 patients with prehospital diagnosis of PATE entered the study. Prehospital clinical and ECG picture was compared in groups of verified PATE (n=61) and rejected PATE (n=41). Clinical probability of PATE was assessed retrospectively according to Revised Geneva Score (RGS) scale. In 47 cases the analysis was made in dynamics (in 92±42.1 min, on the average). Results. In the group of patients with false-positive PATE diagnosis we significantly more frequently observed angina-like chest pain and satisfactory condition at examination, ECG evidence for right heart overloading (the most significant marker S I—Q III; p=0.009) occurred less often, mean heart rate was significantly lower than in patients with verified PATE (85 ± 23,8 and 100±23,0 b/min, respectively; р = 0,007). Low probability of PATE by the RGS scale was stated in 37% patients from the group with false-positive diagnosis and only in 8% patients with a verified diagnosis of PATE (р = 0.0005). Conclusion. Prehospital PATE overdiagnosis can be explained by non-specificity of clinical and ECG picture of the disease in acute period. Application of the RGS scale is effective for objective assessment of the condition and accurate diagnosis. |
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| ISSN: | 0040-3660 2309-5342 |