Abstract
Aims: The Revised Geneva Score (RGS), a standardized Clinical Prediction
Rule for Pulmonary Embolism (PE), was recently developed. We have
measured its predictive accuracy, performing an external retrospective
validation in a cohort of Emergency Department (ED) patients, filtered by
symptomatology and not by clinical suspicion, to allow its use in nursing
practice.
Methods: The clinical probability of PE was assessed in 1013 consecutive
patients with symptoms of “chest pain” or “shortness of breath/dyspnea”,
whose clinical records were obtained during a two months period, in an Italian
ED. The accuracy of RGS was analyzed by the Receiver Operating
Characteristic (ROC) analyses; the OR was evaluated with an analysis of the
risk raw score.
Results: The overall prevalence of PE was 1.09%. The prevalences of PE in the
three probability categories were similar and not statistically significant. The
Area under the Curve was 0.6373 (CI 0.4336-0.8409). However, the NPV was
0.993 (95% CI 0.981-0.998) and the mean score of risk was 3.36 for the 1002
not affected by PE and 5.73 for the 11 subjects with Pulmonary Embolism (p
0.0003), by exclusively assessing it on the raw score obtained.
Conclusions: This study suggests that the performance of the RGS, modified in
order to be applied to a nursing emergency approach, gives good results in
NPV; it should be also tested to assess the embolic risk by a dichotomous
numerical score (rule-in/rule-out), that should be used to supplement rather than
as a substitute for clinical judgement
Lingua originale | Inglese |
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pagine (da-a) | 49-58 |
Numero di pagine | 10 |
Rivista | Iran J Crit Care Nurs |
Volume | 8 |
Numero di pubblicazione | 1 |
Stato di pubblicazione | Pubblicato - 1 gen 2015 |