The diagnostic values of Padua score combined D-Dimer for venous thromboembolism in patients with chronic pulmonary diseases

Abstract

Objective To explore the diagnostic values of the Wells score, the revised Geneva score, the Padua score and the D-dimer level for venous thrombus embolism (VTE) in hospitalized patients with chronic pulmonary diseases. Methods The clinical data of inpatients with chronic pulmonary diseases (n=135) at department of respiratory medicine in Beijing Tongren Hospital from January 2012 to December 2018 were analyzed retrospectively.The Wells score, revised Geneva score and Padua score were calculated to evaluate the diagnosis and risk stratification of VTE, and the patients were divided into VTE group (n=50) and non-VTE group (n=85) according to the imaging results, and the clinical data between the two groups were compared.The diagnostic value of the three scoring systems and D-dimer level were compared by the area under the receiver operating characteristic (ROC) curve, and the Youden Index was calculated for the cut-off point. Results The incidence of VTE in patients with chronic pulmonary diseases was 37.04%.The D-Dimer level in VTE group was higher than that in non-VTE group [M(QR): 2 335(6 670) μg/L vs 400(870) μg/L, P<0.001]. The area under curve(AUC)of the ROC in Wells score, revised Geneva score, Padua score and the D-dimer level was 0.681±0.049, 0.614±0.051, 0.795±0.042, 0.811±0.039, separately.The cut-off of Padua score was 3 points and Youden Index was 0.497.The cut-off of D-dimer level was 1 460 μg/L and Youden Index was 0.519.The AUC of Padua score combined with D-dimer (0.865±0.034) was higher than that of Padua (P=0.009) or D-dimer (P=0.087), separately. Conclusions The index of Padua score combined with plasma D-dimer has the highest value in the diagnosis of VTE in patients with chronic pulmonary diseases, which can provide reference for timely, reasonable and standardized selection of imaging diagnosis, and further to improve the diagnostic accuracy and optimize the allocation of medical resources. Key words: Venous thromboembolism; Diagnosis; Lung disease