Screening for postoperative pulmonary embolism using a combination of symptoms and signs of PE and deep vein thrombosis, plus tachycardia, achieved a sensitivity of 85%.
Observational (n=108)
Do clinical symptoms, routine ECG, and chest radiography accurately screen for postoperative pulmonary embolism in patients undergoing elective hip surgery?
A simple clinical screening approach combining symptoms of pulmonary embolism, deep vein thrombosis, and tachycardia provides 85% sensitivity for detecting postoperative pulmonary embolism after hip surgery.
The incidence of pulmonary embolism (PE) and the usefulness of various screening methods for its detection were studied in 108 patients undergoing elective hip surgery. Twenty patients had PE as shown by perfusion-ventilation lung scintigraphy. Six of them had symptoms of embolism. Clinical symptoms of PE, highly suggestive electrocardiographic (ECG) signs and signs in chest radiographs showed high specificity but low sensitivity with regard to PE. If the non-specific ECG signs and the symptoms and signs of deep vein thrombosis in the calves had also been taken into account, it would have been possible to identify 95% of the patients with PE. The use of all these screening tests revealed a suspicion of PE in two thirds of the patients. The simplest way to screen for postoperative PE seems to be to use a combination of the symptoms and signs of both PE and deep vein thrombosis, and to identify any tachycardia. This method gave a sensitivity of 85%.
Rissanen et al. (Thu,) conducted a observational in Postoperative pulmonary embolism (n=108). Clinical symptomatology, routine electrocardiography, and plain chest radiography vs. Perfusion-ventilation lung scintigraphy was evaluated on Sensitivity for detection of pulmonary embolism. Screening for postoperative pulmonary embolism using a combination of symptoms and signs of PE and deep vein thrombosis, plus tachycardia, achieved a sensitivity of 85%.
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