Pulmonary artery thromboembolism: Factors of prehospital overdiagnosis. Ermolaev, A., A., Plavunov, N., F., Spiridonova, E., A., Baratashvili, V., L., & Stazhadze, L., L. Terapevticheskii Arkhiv, 84(4):17-22, 2012.
Pulmonary artery thromboembolism: Factors of prehospital overdiagnosis [link]Website  abstract   bibtex   
Aim: Detection and analysis of factors of pulmonary artery thromboembolism (PATE) overdiagnosis in a prehospital setting. Material and methods: A total of 102 patients with prehospital diagnosis of PATE entered the study. Prehospital clinical and ECG picture was compared in groups of verified PATE (n=61) and rejected PATE (n=41). Clinical probability of PATE was assessed retrospectively according to Revised Geneva Score (RGS) scale. In 47 cases the analysis was made in dynamics (in 92±42.1 min, on the average). Results: In the group of patients with false-positive PATE diagnosis we significantly more frequently observed angina-like chest pain and satisfactory condition at examination, ECG evidence for right heart overloading (the most significant marker SI-QIIP p=0.009) occurred less often, mean heart rate was significantly lower than in patients with verified PATE (85 ± 23,8 and 100±23,0 b/min, respectively; p = 0,007). Low probability of PATE by the RGS scale was stated in 37% patients from the group with false-positive diagnosis and only in 8% patients with a verified diagnosis of PATE (p = 0.0005). Conclusion: Prehospital PATE overdiagnosis can be explained by non-specificity of clinical and ECG picture of the disease in acute period. Application of the RGS scale is effective for objective assessment of the condition and accurate diagnosis.
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 title = {Pulmonary artery thromboembolism: Factors of prehospital overdiagnosis},
 type = {article},
 year = {2012},
 identifiers = {[object Object]},
 keywords = {Overdiagnosis,Prehospital setting,Pulmonary artery thromboembolism},
 pages = {17-22},
 volume = {84},
 websites = {https://elibrary.ru/item.asp?id=20155607,http://www.ncbi.nlm.nih.gov/pubmed/22774485},
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 abstract = {Aim: Detection and analysis of factors of pulmonary artery thromboembolism (PATE) overdiagnosis in a prehospital setting. Material and methods: A total of 102 patients with prehospital diagnosis of PATE entered the study. Prehospital clinical and ECG picture was compared in groups of verified PATE (n=61) and rejected PATE (n=41). Clinical probability of PATE was assessed retrospectively according to Revised Geneva Score (RGS) scale. In 47 cases the analysis was made in dynamics (in 92±42.1 min, on the average). Results: In the group of patients with false-positive PATE diagnosis we significantly more frequently observed angina-like chest pain and satisfactory condition at examination, ECG evidence for right heart overloading (the most significant marker SI-QIIP p=0.009) occurred less often, mean heart rate was significantly lower than in patients with verified PATE (85 ± 23,8 and 100±23,0 b/min, respectively; p = 0,007). Low probability of PATE by the RGS scale was stated in 37% patients from the group with false-positive diagnosis and only in 8% patients with a verified diagnosis of PATE (p = 0.0005). Conclusion: Prehospital PATE overdiagnosis can be explained by non-specificity of clinical and ECG picture of the disease in acute period. Application of the RGS scale is effective for objective assessment of the condition and accurate diagnosis.},
 bibtype = {article},
 author = {Ermolaev, A. A. and Plavunov, N. F. and Spiridonova, E. A. and Baratashvili, V. L. and Stazhadze, L. L.},
 journal = {Terapevticheskii Arkhiv},
 number = {4}
}
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