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Title

Stratégie diagnostique et intérêt comparatif des scores cliniques pour le diagnostic d'embolie pulmonaire
Authors
Blondon, Marc
Le Gal, G.
Righini, Marc Philip
Published in La Revue de médecine interne. 2010, vol. 31, no. 11, p. 742-749
Abstract The diagnostic approach to pulmonary embolism can be divided in several consecutive steps. First of all, the clinician must identify the patients with potential pulmonary embolism based on clinical presentation and the presence or absence of personal risk factors. Further investigations can then be guided by the use of a clinical probability score. The revised Geneva score and the Wells score are the most validated tools. They are reliable in stratifying patients into low, intermediate, and high-risk categories. When clinical probability is low or intermediate, the dosage of d-dimers is helpful. A negative result excludes pulmonary embolism with a very high negative predictive value, close to 100%. When positive, a multidetector thoracic CT will confirm or exclude the diagnosis. The utility of a lower-limb venous ultrasound is very low, and its use is therefore no longer recommended.
Keywords Enzyme-Linked Immunosorbent Assay — Factor V/genetics — Humans — Odds Ratio — Predictive Value of Tests — Pulmonary Embolism/*diagnosis/etiology/radiography/ultrasonography — Radiography, Thoracic — Reproducibility of Results — Risk Factors — Tomography, X-Ray Computed
Identifiers
PMID: 20800323
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Structures
Faculté de médecine / Section de médecine clinique / Département de médecine
Citation
(ISO format) 		BLONDON, Marc, LE GAL, G., RIGHINI, Marc Philip. Stratégie diagnostique et intérêt comparatif des scores cliniques pour le diagnostic d'embolie pulmonaire. In: La Revue de médecine interne, 2010, vol. 31, n° 11, p. 742-749. doi: 10.1016/j.revmed.2010.07.012 https://archive-ouverte.unige.ch/unige:20785

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Deposited on : 2012-05-23

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