Diagnostic predictive value of simplified Geneva score combined with age-adjusted D-dimer for pulmonary thromboembolism

Abstract

Objective To investigate the diagnostic predictive value of simplified Geneva score (SGS), age-adjusted D-dimer (AADD) and their combination for pulmonary thromboembolism (PTE). Methods The study subjects were 102 hospitalized patients with suspected PTE from December 2016 to December 2017 in the First Affiliated Hospital of Shanxi Medical University.SGS was performed in all included patients and AADD was collected, with computed tomography and/or ventilation/perfusion positive results as the gold standard for the diagnosis of PTE.The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and Yoden index of SGS, AADD and SGS combined with AADD were calculated and the diagnostic value of PTE was analyzed. Results Of the 102 patients with suspected PTE, 31 cases (30.4%) were diagnosed with PTE, and 71 cases (69.6%) were excluded from PTE.The sensitivity of SGS in diagnosing PTE was 80.6%, specificity was 76.1%, positive predictive value was 59.5%, negative predictive value was 90.0%, positive likelihood ratio was 3.37, negative likelihood ratio was 0.25, and Youden index was 0.567.The sensitivity of AADD in diagnosing PTE was 93.5%, specificity was 63.4%, positive predictive value was 52.7%, negative predictive value was 95.7%, positive likelihood ratio was 2.55, negative likelihood ratio was 0.10, and Youden index was 0.569.The sensitivity of SGS combined with AADD in diagnosing PTE was 92.0%, specificity was 90.4%, positive predictive value was 82.1%, negative predictive value was 95.9%, positive likelihood ratio was 9.58, negative likelihood ratio was 0.09, and Youden index was 0.824. Conclusions The combination of SGS and AADD can significantly improve the diagnostic efficacy of PTE, and its negative predictive value and positive predictive value are higher than when used alone. Key words: Pulmonary thromboembolism; Simplified Geneva score; Age-adjusted D-dimer; Forecasting