Performance of the Wells score in patients with suspected pulmonary embolism during hospitalization: a delayed-type cross sectional study in a community hospital.

MARIA LOURDES POSADAS MARTINEZ; FERNANDO VAZQUEZ; GIUNTA D; WAISMAN; FERNAN GONZALEZ BERNALDO DE QUIROS; ESTEBAN GANDARA

THROMBOSIS RESEARCH

PERGAMON-ELSEVIER SCIENCE LTD

Lugar: Amsterdam; Año: 2014

0049-3848

Introduction: The role of the Wells score for patients who develop signs and symptoms of pulmonary embolism(PE) during hospitalization has not been sufficiently validated. The aim of this study is to evaluate the performance of theWells score for inpatients with suspected PE and to evaluate the prevalence of pulmonary embolism.Materials and Methods: We conducted a cross sectional study nested in the prospective Institutional Registry ofThromboembolic Disease at Hospital Italiano de Buenos Aires from June 2006 to March 2011. We includedpatients who developed symptoms of pulmonary embolism during hospitalization. Patients were stratifiedbased on the Wells score as PE likely (N4 points) or PE unlikely (≤4 points). The presence of pulmonary embolismwas defined by pre-specified criteria.Results: Six hundred and thirteen patients met the inclusion criteria, with an overall prevalence of PE of 36%. Twohundred and nineteen (34%) were classified as PE likely and 394 (66%) as PE unlikely with a prevalence of PE of66% and 20%, respectively. TheWells score showed a sensitivity of 65 (95% CI 59-72), specificity 81 (95% CI 77-85),positive predictive value 66 (95% CI 60-72) and negative predictive value 80 (95% CI 77-84).Conclusions: The Wells Score is accurate to predict the probability of PE in hospitalized patients and this populationhad a higher prevalence of PE than other cohorts. However, the score is not sufficiently predictive to rule out apotentially fatal disorder.