A Retrospective Evaluation of Patients Admitted to Emergency Departments with Pulmonary Thromboembolism

DURAN, Latif; YAVUZ, Yücel; GÜZEL, Aygül; ŞİŞMAN, Bülent; ALTUNTAŞ, Mehmet; MURAT, NACİ

A Retrospective Evaluation of Patients Admitted to Emergency Departments with Pulmonary Thromboembolism

Aygül GÜZEL, (Ondokuz Mayıs Üniversitesi, Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, Samsun, Türkiye)

Yücel YAVUZ, (Ondokuz Mayıs Üniversitesi, Tıp Fakültesi, Acil Tıp Anabilim Dalı, Samsun, Türkiye)

Bülent ŞİŞMAN, (Sinop Devlet Hastanesi, Acil Servis, Sinop, Türkiye)

Latif DURAN, (Ondokuz Mayıs Üniversitesi, Tıp Fakültesi, Acil Tıp Anabilim Dalı, Samsun, Türkiye)

Mehmet ALTUNTAŞ, (Ondokuz Mayıs Üniversitesi, Tıp Fakültesi, Acil Tıp Anabilim Dalı, Samsun, Türkiye)

Naci MURAT (Ondokuz Mayıs Üniversitesi, Tıp Fakültesi, İstatistik Anabilim Dalı, Samsun, Türkiye)

Eurasian Journal of Emergency Medicine

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Yıl: 2015 Cilt: 14 Sayı: 1 Sayfa Aralığı: 8 - 11 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

A Retrospective Evaluation of Patients Admitted to Emergency Departments with Pulmonary Thromboembolism

Öz:

Amaç: Pulmoner tromboemboli (PTE) tanısı ile acil servisimize başvuran hastaların klinik, radyolojik ve laboratuar bulgularını incelemek ve klinik skorlamaların tanıdaki etkinliğini değerlendirmektir. Gereç ve Yöntemler: Bu çalışmada üniversitemiz acil servisine başvuran 33 pulmoner tromboemboli olgusu geriye dönük olarak incelendi. Bulgular: Olguların yaş ortalaması 56,2±18,2 yıl idi. Kadın/erkek oranı ise 1,5 idi. Başvuru yakınmaları arasında en sık neden nefes darlığı (%51,5) idi. Risk faktörleri arasında ise çoğunluğu (%39,3) operasyona bağlı immobilizasyon hikayesi oluşturmaktaydı. Well's klinik skorlamasına göre olguların 29'u (%87,8) yüksek olasılıklı iken modifiye geneva skoruna göre ise olguların 18'i (%55,5) yüksek olasılıklı grupta idi. Well's skorunun yüksek olasılıklı PTE tahmin oranı Modifiye Geneva skoruna göre anlamlı oranda fazla idi (p=0,017). En sık görülen klinik bulgular taşipne (%69,6) ve taşikardi (%27,3) idi. 15 (%45,4) olguda patolojik akci- ğer grafisi vardı. Bilgisayarlı Tomografik (BT) Anjiografide PTE en sık bilateral pulmoner ana dallara yerleşim göstermekte idi. Yirmi yedi (%81,8) olguya standart düşük molekül ağırlıklı heparin+warfarin tedavisi uygulanırken 6 (%18,2) olguya ise doku plazminojen aktivatörü (tPA) tedavisi uygulanmıştı. Sonuç: PTE tanısında; klinik, laboratuar ve radyolojik bulguların birlikte değerlendirilmesi önemlidir. PTE kuşkusu olan hastaların klinik olasılık tahmininde Well's skorunun kullanımı tercih edilmelidir.

Anahtar Kelime:

Konular: Acil Tıp

Acil Servise Başvuran Pulmoner Tromboemboli Olgularının Retrospektif Olarak Değerlendirilmesi

Öz:

Aim: To examine the clinical, radiological, and laboratory findings of pulmonary thromboembolism (PTE) patients who were admitted to our emergency department and to evaluate the effectiveness of clinical diagnosis scores.Materials and Methods: We retrospectively evaluated 33 PTE patients who were referred to our emergency department. Results: The mean age of the patients was 56.2±18.2 years. The female:male ratio was 1.5. The most common cause of complaints was dyspnoea (51.5%). Risk factors in the majority (39.3%) included immobilisation due to surgery. According to the Wells clinical scoring system, 29 patients (87.8%) had a high probability of PTE; however, 18 of the patients (55.5%) had high probability of PTE according to the modified Geneva score. The estimated rate ratio of high probability of PTE with the Wells score was statistically significant compared with the estimate rate ration with the modified Geneva score (p=0.017). The most common clinical findings included tachypnoea (69.6%) and tachycardia (27.3%). Fifteen (45.4%) patients had pathologic chest X-ray findings. Computed tomographic (CT) angiography most often showed PTE placement of the bilateral pulmonary main branches. While standard low-molecular-weight heparin and warfarin treatment was administered to 27 (81.8%) patients, tissue plasminogen activator (tPA) treatment was administered to 6 (18.2%) patients. Conclusion: The evaluation of clinical, laboratory and radiological findings together in PTE diagnosis is important. It is preferable to use the Wells score for the estimation of clinical probability in patients with suspected PTE

Anahtar Kelime:

Konular: Acil Tıp

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

Editör: Umut S. Sayral BS. Pulmoner Tromboembolizm Tanı ve Tedavi Uzlaşı Raporu. Turk Thorac J 2010; 10: 7-46.
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APA	GÜZEL A, YAVUZ Y, ŞİŞMAN B, DURAN L, ALTUNTAŞ M, MURAT N (2015). A Retrospective Evaluation of Patients Admitted to Emergency Departments with Pulmonary Thromboembolism. , 8 - 11.
Chicago	GÜZEL Aygül,YAVUZ Yücel,ŞİŞMAN Bülent,DURAN Latif,ALTUNTAŞ Mehmet,MURAT NACİ A Retrospective Evaluation of Patients Admitted to Emergency Departments with Pulmonary Thromboembolism. (2015): 8 - 11.
MLA	GÜZEL Aygül,YAVUZ Yücel,ŞİŞMAN Bülent,DURAN Latif,ALTUNTAŞ Mehmet,MURAT NACİ A Retrospective Evaluation of Patients Admitted to Emergency Departments with Pulmonary Thromboembolism. , 2015, ss.8 - 11.
AMA	GÜZEL A,YAVUZ Y,ŞİŞMAN B,DURAN L,ALTUNTAŞ M,MURAT N A Retrospective Evaluation of Patients Admitted to Emergency Departments with Pulmonary Thromboembolism. . 2015; 8 - 11.
Vancouver	GÜZEL A,YAVUZ Y,ŞİŞMAN B,DURAN L,ALTUNTAŞ M,MURAT N A Retrospective Evaluation of Patients Admitted to Emergency Departments with Pulmonary Thromboembolism. . 2015; 8 - 11.
IEEE	GÜZEL A,YAVUZ Y,ŞİŞMAN B,DURAN L,ALTUNTAŞ M,MURAT N "A Retrospective Evaluation of Patients Admitted to Emergency Departments with Pulmonary Thromboembolism." , ss.8 - 11, 2015.
ISNAD	GÜZEL, Aygül vd. "A Retrospective Evaluation of Patients Admitted to Emergency Departments with Pulmonary Thromboembolism". (2015), 8-11.

APA	GÜZEL A, YAVUZ Y, ŞİŞMAN B, DURAN L, ALTUNTAŞ M, MURAT N (2015). A Retrospective Evaluation of Patients Admitted to Emergency Departments with Pulmonary Thromboembolism. Eurasian Journal of Emergency Medicine, 14(1), 8 - 11.
Chicago	GÜZEL Aygül,YAVUZ Yücel,ŞİŞMAN Bülent,DURAN Latif,ALTUNTAŞ Mehmet,MURAT NACİ A Retrospective Evaluation of Patients Admitted to Emergency Departments with Pulmonary Thromboembolism. Eurasian Journal of Emergency Medicine 14, no.1 (2015): 8 - 11.
MLA	GÜZEL Aygül,YAVUZ Yücel,ŞİŞMAN Bülent,DURAN Latif,ALTUNTAŞ Mehmet,MURAT NACİ A Retrospective Evaluation of Patients Admitted to Emergency Departments with Pulmonary Thromboembolism. Eurasian Journal of Emergency Medicine, vol.14, no.1, 2015, ss.8 - 11.
AMA	GÜZEL A,YAVUZ Y,ŞİŞMAN B,DURAN L,ALTUNTAŞ M,MURAT N A Retrospective Evaluation of Patients Admitted to Emergency Departments with Pulmonary Thromboembolism. Eurasian Journal of Emergency Medicine. 2015; 14(1): 8 - 11.
Vancouver	GÜZEL A,YAVUZ Y,ŞİŞMAN B,DURAN L,ALTUNTAŞ M,MURAT N A Retrospective Evaluation of Patients Admitted to Emergency Departments with Pulmonary Thromboembolism. Eurasian Journal of Emergency Medicine. 2015; 14(1): 8 - 11.
IEEE	GÜZEL A,YAVUZ Y,ŞİŞMAN B,DURAN L,ALTUNTAŞ M,MURAT N "A Retrospective Evaluation of Patients Admitted to Emergency Departments with Pulmonary Thromboembolism." Eurasian Journal of Emergency Medicine, 14, ss.8 - 11, 2015.
ISNAD	GÜZEL, Aygül vd. "A Retrospective Evaluation of Patients Admitted to Emergency Departments with Pulmonary Thromboembolism". Eurasian Journal of Emergency Medicine 14/1 (2015), 8-11.