The application of a clinical risk stratification score may reduce unnecessary investigations for pulmonary embolism in pregnancy.

Hdl Handle:
http://hdl.handle.net/10147/217176
Title:
The application of a clinical risk stratification score may reduce unnecessary investigations for pulmonary embolism in pregnancy.
Authors:
O'Connor, Clare; Moriarty, John; Walsh, Jennifer; Murray, John; Coulter-Smith, Sam; Boyd, William
Affiliation:
Department of Obstetrics and Gynaecology, National Maternity Hospital, Dublin, Ireland.
Citation:
The application of a clinical risk stratification score may reduce unnecessary investigations for pulmonary embolism in pregnancy. 2011, 24 (12):1461-4 J. Matern. Fetal. Neonatal. Med.
Journal:
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
Issue Date:
Dec-2011
URI:
http://hdl.handle.net/10147/217176
DOI:
10.3109/14767058.2011.614652
PubMed ID:
21854126
Abstract:
To examine the use of the modified Wells score in pregnancy as a risk stratification tool in the diagnosis of pulmonary embolism (PE).; All pregnant or post-partum patients who were referred for CT Pulmonary Angiography (CTPA) to evaluate suspected PE over a 5-year period were included in the study. Patient records were used to apply the modified Wells score (MWS) and analyze their risk of PE.; A total of 125 women were referred for CTPA over 5 years. A MWS of 6 or greater ("High Risk") was 100% sensitive and 90% specific with a positive predictive value of 36% for PE on CTPA. No patients with a low MWS (less than 6) had a PE, giving a negative predictive value of 100%. p≤0.001. D-dimers, chest X-ray, blood gases and EKG were significantly less effective than the MWS in aiding the diagnosis of PE.; Current methods employed for the diagnosis of PE are inadequate. Risk stratification using the MWS may allow safe exclusion of PE before resorting to CTPA. To the best of our knowledge this is the first study to have used the MWS in a pregnant patient group.
Language:
en
MeSH:
Algorithms; Angiography; Cohort Studies; Down-Regulation; Female; Humans; Predictive Value of Tests; Pregnancy; Pregnancy Complications, Cardiovascular; Prenatal Diagnosis; Prognosis; Pulmonary Embolism; Research Design; Retrospective Studies; Risk Factors; Unnecessary Procedures
ISSN:
1476-4954
Ethical Approval:
N/A

Full metadata record

DC FieldValue Language
dc.contributor.authorO'Connor, Clare-
dc.contributor.authorMoriarty, John-
dc.contributor.authorWalsh, Jennifer-
dc.contributor.authorMurray, John-
dc.contributor.authorCoulter-Smith, Sam-
dc.contributor.authorBoyd, William-
dc.date.accessioned2012-03-30T13:45:21Z-
dc.date.available2012-03-30T13:45:21Z-
dc.date.issued2011-12-
dc.identifier.citationThe application of a clinical risk stratification score may reduce unnecessary investigations for pulmonary embolism in pregnancy. 2011, 24 (12):1461-4 J. Matern. Fetal. Neonatal. Med.-
dc.identifier.issn1476-4954-
dc.identifier.pmid21854126-
dc.identifier.doi10.3109/14767058.2011.614652-
dc.identifier.urihttp://hdl.handle.net/10147/217176-
dc.description.abstractTo examine the use of the modified Wells score in pregnancy as a risk stratification tool in the diagnosis of pulmonary embolism (PE).-
dc.description.abstractAll pregnant or post-partum patients who were referred for CT Pulmonary Angiography (CTPA) to evaluate suspected PE over a 5-year period were included in the study. Patient records were used to apply the modified Wells score (MWS) and analyze their risk of PE.-
dc.description.abstractA total of 125 women were referred for CTPA over 5 years. A MWS of 6 or greater ("High Risk") was 100% sensitive and 90% specific with a positive predictive value of 36% for PE on CTPA. No patients with a low MWS (less than 6) had a PE, giving a negative predictive value of 100%. p≤0.001. D-dimers, chest X-ray, blood gases and EKG were significantly less effective than the MWS in aiding the diagnosis of PE.-
dc.description.abstractCurrent methods employed for the diagnosis of PE are inadequate. Risk stratification using the MWS may allow safe exclusion of PE before resorting to CTPA. To the best of our knowledge this is the first study to have used the MWS in a pregnant patient group.-
dc.language.isoen-
dc.rightsArchived with thanks to The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetriciansen_GB
dc.subject.meshAlgorithms-
dc.subject.meshAngiography-
dc.subject.meshCohort Studies-
dc.subject.meshDown-Regulation-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshPredictive Value of Tests-
dc.subject.meshPregnancy-
dc.subject.meshPregnancy Complications, Cardiovascular-
dc.subject.meshPrenatal Diagnosis-
dc.subject.meshPrognosis-
dc.subject.meshPulmonary Embolism-
dc.subject.meshResearch Design-
dc.subject.meshRetrospective Studies-
dc.subject.meshRisk Factors-
dc.subject.meshUnnecessary Procedures-
dc.titleThe application of a clinical risk stratification score may reduce unnecessary investigations for pulmonary embolism in pregnancy.en_GB
dc.contributor.departmentDepartment of Obstetrics and Gynaecology, National Maternity Hospital, Dublin, Ireland.-
dc.identifier.journalThe journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians-
dc.type.qualificationlevelN/Aen
cr.approval.ethicalN/Aen
dc.description.provinceLeinsteren
dc.description.provinceLeinster-

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