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Master Thesis

Intérêt du score de probabilité clinique de Genève pour limiter le risque de démarche inappropriée‎ : étude rétrospective d'une cohorte de patients admis dans un service d'urgence pour suspicion d'embolie pulmonaire

Abstract : INTRODUCTION: Venous thromboembolic disease remains a leading cause of mortality. Chest CT scan is the diagnostic gold standard of pulmonary embolism (PE). The prevalence of PE among patients who underwent chest CT scan is modest in previous studies, about 10%. The primary objective was to compare the diagnostic performance of the Geneva score with the subjective clinical suspicion in the emergency room. METHODS: This retrospective single-center cohort study, included patients with suspected PE, admitted to the clinique mutualiste's emergency, Grenoble, France, 1 August 2011 to 1 August 2012. The indication of the chest CT scan was reassessed by conducting a score of Geneva modified, a posteriori. RESULTS: The analysis included 1874 patients. The study confirmed the assessed of the modified Geneva score by the area under the ROC curve, significantly higher than subjective clinical intuition performance. The prevalence of PE among chest CT scan made was 13.2% in our cohort compared with a prevalence of 23-26% found in the literature when the Geneva's score is used. The use of a diagnostic strategy based on clinical probability scores would probably have avoided the unnecessary 93 of 789 chest CT scan done. DISCUSSION: The use of diagnostic written or digital strategy's guides including a score could increase the performance with suspected PE patients.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-00919274
Contributor : Jean-Hugues Morneau <>
Submitted on : Monday, December 16, 2013 - 3:09:19 PM
Last modification on : Tuesday, May 11, 2021 - 11:36:16 AM
Long-term archiving on: : Tuesday, March 18, 2014 - 4:47:12 PM

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  • HAL Id : dumas-00919274, version 1

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Michaël Lévy. Intérêt du score de probabilité clinique de Genève pour limiter le risque de démarche inappropriée‎ : étude rétrospective d'une cohorte de patients admis dans un service d'urgence pour suspicion d'embolie pulmonaire. Médecine humaine et pathologie. 2013. ⟨dumas-00919274⟩

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