Management of pulmonary embolism at emergency department

Master thesis of Akvilina Žiūkaitė. Management of pulmonary embolism at emergency department. The supervisor is Diana Barkauskienė. Lithuanian University of Health Sciences, Medical Academy, Medical Faculty, Lithuanian University of Health Sciences Kaunas Clinics, Pulmonary Clinic. Kaunas, 2017. The objective of this study: evaluate clinical probability for patients with suspected pulmonary embolism at emergency department. Tasks: 1. To estimate demographic characteristics of patients with suspected pulmonary embolism. 2. To compare clinical signs and symptoms of patients with confirmed and refuted pulmonary embolism. 3. To estimate predictive values of the Wells score, the Geneva, simplified Wells and simplified Geneva score in management of pulmonary embolism. Material and methods. Retrospective data analysis of 227 patients with suspecter pulmonary embolism in 20014-2015 at emergency department were performed. Patients were divided into two groups: patiens with confirmed pulmonary embolism and patiens with refuted pulmonary embolism. The comprehensive degree of accuracy of the Wells, the Geneva and simplified scores was compared using area under the curve (AUC) of receiver operating characteristic (ROC) curves. Results. There were 227 people: 97 (42,7%) with confirmed PE and 130 (57,3%) with refuted PE. Mean age was 67,88±14,11 years patiens with PE and 68,68±14,49 years patiens with refuted PE, (p>0,05). The incidence of syncope and deep vein thrombosis was significantly higher in patients with confirmed PE than in patiens with refuted PE (p<0,05). The incidens of hart failure was higher in patients with refuted PE (p