A Retrospective Evaluation of Patients Admitted to Emergency Departments with Pulmonary Thromboembolism

Abstract

Aim: To examine the clinical, radiological, and laboratory findings of pulmonary thromboembolism (PTE) patients who were admitted to our emergency department and to evaluate the effectiveness of clinical diagnosis scores. Materials and Methods: We retrospectively evaluated 33 PTE patients who were referred to our emergency department. Results: The mean age of the patients was 56.2 +/- 18.2 years. The female: male ratio was 1.5. The most common cause of complaints was dyspnoea (51.5%). Risk factors in the majority (39.3%) included immobilisation due to surgery. According to the Wells clinical scoring system, 29 patients (87.8%) had a high probability of PTE; however, 18 of the patients (55.5%) had high probability of PTE according to the modified Geneva score. The estimated rate ratio of high probability of PTE with the Wells score was statistically significant compared with the estimate rate ration with the modified Geneva score (p=0.017). The most common clinical findings included tachypnoea (69.6%) and tachycardia (27.3%). Fifteen (45.4%) patients had pathologic chest X-ray findings. Computed tomographic (CT) angiography most often showed PTE placement of the bilateral pulmonary main branches. While standard low-molecular-weight heparin and warfarin treatment was administered to 27 (81.8%) patients, tissue plasminogen activator (tPA) treatment was administered to 6 (18.2%) patients. Conclusion: The evaluation of clinical, laboratory and radiological findings together in PTE diagnosis is important. It is preferable to use the Wells score for the estimation of clinical probability in patients with suspected PTE.