Présentation clinique, paraclinique et sensibilité des scores diagnostiques de l’embolie pulmonaire aux urgences : étude rétrospective de l’effet de l’âge au CHRU de Strasbourg [Clinical and paraclinical patterns of presentation, and sensitivity of diagnostic scores for pulmonary embolism at the emergencies: retrospective study on the impact of age at the University hospitals of Strasbourg (France)]

Détails

ID Serval
serval:BIB_997DB564D777
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Présentation clinique, paraclinique et sensibilité des scores diagnostiques de l’embolie pulmonaire aux urgences : étude rétrospective de l’effet de l’âge au CHRU de Strasbourg [Clinical and paraclinical patterns of presentation, and sensitivity of diagnostic scores for pulmonary embolism at the emergencies: retrospective study on the impact of age at the University hospitals of Strasbourg (France)]
Périodique
Geriatrie et psychologie neuropsychiatrie du vieillissement
Auteur⸱e⸱s
Boussuge A., Boidevézi A., Vogel T., Schmitt E., Lefebvre F., Bilbault P., Lang P.O.
ISSN
2115-7863 (Electronic)
ISSN-L
2115-7863
Statut éditorial
Publié
Date de publication
01/12/2018
Peer-reviewed
Oui
Volume
16
Numéro
4
Pages
349-358
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
The diagnosis of pulmonary embolism remains difficult. The objective of this study was to analyze the effect of age on the clinical presentation mode and the sensitivity of the diagnostic scores.
In retrospect, all patients discharged with a documented diagnosis of pulmonary embolism from the adult emergency service of the Regional university hospital of Strasbourg (France) over a year were considered. According to 4 age categories (<70, 70-74, 75-80 and >80 years) the data from the medical records were analyzed and compared. Diagnostic scores of Wells and modified Geneva were calculated.
117 patients met the inclusion criteria (mean age 71.8±13.8 years, women 54%). Chest pain was less common after 80 years; no difference was observed for syncope or dyspnea although the oxygen saturation is lower in old age. For diagnosis, 25% of patients had a lung scintigraphy with an increased recourse with age (<70 years: 10%, >80 years: 41%). Thoracic computed tomography angiography concerned 79% of patients with a significant decrease of his use in older. The sensitivity of the diagnostic scores was low but increased with age when the strong and intermediate probabilities of pulmonary embolism were combined.
This study confirms the low specificity of the clinical signs of pulmonary embolism, whatever the age. It also shows the low sensitivity of the diagnostic scores in the 70 years or older.
Mots-clé
Age Factors, Aged, Aged, 80 and over, Chest Pain/diagnosis, Emergency Medical Services, Female, France, Hospitals, University, Humans, Male, Middle Aged, Pulmonary Embolism/diagnosis, Retrospective Studies, Sensitivity and Specificity, Syncope/diagnosis, aged people, clinical features, diagnosis, pulmonary embolism
Pubmed
Web of science
Création de la notice
26/11/2018 13:48
Dernière modification de la notice
20/08/2019 15:00
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