Cor Vasa 2024, 66(1):17-21 | DOI: 10.33678/cor.2023.098

(Pulmonary embolism in the Tábor region - revised Geneva score and other predictors of PE on CT pulmonary angiogram)

Jiří Adámek, Jan Kuchař

Interní oddělení II, Nemocnice Tábor a.s., Tábor, Česká republika

Aim: Analysis of the data of patients investigated in the Tabor Hospital for suspected pulmonary embolism with CT pulmonary angiogram (CTPA) in one year from March 2019 until February 2020. Evaluation of the usefulness of the Revised Geneva Score (RGS) in this group.

Methods: Retrospective analysis of the data of all patients who underwent CTPA for suspected pulmonary embolism in the Department of Radiology in Tábor Hospital from March 2019 until February 2020. RGS value was calculated and compared with known CTPA results. Other clinical and laboratory parameters and their usefulness in prediction of pulmonary embolism diagnosis on CTPA were evaluated.

Results: Total 584 consecutive patients were analysed. Three patients were excluded due to missing data. Pulmonary embolism was diagnosed in 132 (22.6%) patients (71 men, 53.8%); given the population of the Tábor region 102 451 inhabitants it means that the pulmonary embolism incidence is almost 129/100 000. Low probability of pulmonary embolism according to RGS was estimated in 37.2% patients, intermediate probability in 62.5%, high probability in 0.3%. The most frequent symptom was dyspnea (342 patients; 58%). The AUC of RGS in this cohort was 0.64. In a multivariate analysis, the predictors of pulmonary embolism on CTPA were RGS (OR 1.27 for one point, p <0,001) and D-dimers (OR 1.19 for µg/L, p <0.001), masculine sex (OR 1.99, p = 0.031). History of ischemic heart disease was a negative predictor (OR 0.31, p = 0.027). Even the combined model is insufficient to replace CTPA (AUC 0.78).

Conclusion: Our cohort shows higher than usually reported incidence of pulmonary embolism. It confirms the trend of increasing pulmonary embolism incidence. The usefulness of RGS in patients already indicated to CTPA is relatively low. Even a combined model with RGS and other predictors including D-dimers is insuf- ficient to replace CTPA in such patients.

Keywords: Pulmonary embolism, Pulmonary embolism incidence, Revised Geneva score

Received: October 3, 2023; Revised: December 14, 2023; Accepted: December 26, 2023; Prepublished online: June 2, 2012; Published: March 5, 2024  Show citation