Skip to Main content Skip to Navigation
Master Thesis

Comparaison des scores de Wells et de Genève révisé simplifié chez les personnes âgées de plus de 65 ans pour le diagnostic d'embolie pulmonaire

Abstract : Introduction: the Pulmonary Embolism (PE) is frequent in the elderly, the incidence is multiplied by 2. The comorbidity makes difficult the realization and the interpretation of the examinations. The aim of our study is to determinate in the patient's of more than 65 years a score which with d-dimer allows to eliminate with safety the PE without imaging. Method: it’s about an ancillary study of the ADJUST study concerning the patients of more than 65 years. The Wells score was calculated for all patients and the items of the Geneva Revised and Simplified Score (GRSS) were recorded at the inclusion of the study. Results: 1546 patients had more of 65ans in the basis of ADJUST. 873 Dutch patients were excluded because all the items of the GRSS were not informed. The study concerned the French, Belgian, and Swiss patients. The GRSS associated with d-dimer is more effective than the Wells score to exclude PE without imagings. 198 patients had no imagings with the GRSS with 0 % of EP (IC95 % 0,0-1,9). While with the Wells score in 2 categories only 166 patients had no imaging with 0 % of EP (IC95 % 0,0-2,3). The Wells score in 3 categories allows more dosage of d-dimer (202 patients) but with 1 % of PE (IC95 %, 0.3-3.5) Discussion: the study shows that the GRSS associated with d-dimer is better than the Wells score in 2 or 3 categories to eliminate PE without imaging in patients most than 65 years. We have to discuss these results because in our study prevalence of PE in the low probability group of Wells score is superior to that of the intermediate probability, because of a misuse of the item "alternative diagnosis". Our study remains original because no study realized a direct comparison between these scores at the elderly.
Document type :
Master Thesis
Complete list of metadata

Cited literature [33 references]  Display  Hide  Download

https://dumas.ccsd.cnrs.fr/dumas-01164508
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Wednesday, June 17, 2015 - 10:28:28 AM
Last modification on : Wednesday, August 23, 2017 - 4:30:16 PM
Long-term archiving on: : Tuesday, September 15, 2015 - 5:41:07 PM

Identifiers

  • HAL Id : dumas-01164508, version 1

Collections

Citation

Meïssa Kare. Comparaison des scores de Wells et de Genève révisé simplifié chez les personnes âgées de plus de 65 ans pour le diagnostic d'embolie pulmonaire. Médecine humaine et pathologie. 2015. ⟨dumas-01164508⟩

Share

Metrics

Record views

1018

Files downloads

4791