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dc.contributor.author
Maritano Furcada, Joaquín  
dc.contributor.author
Castro, Horacio Matías  
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de Vito, Eduardo  
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Grande Ratti, María Florencia  
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Posadas Martinez, Maria Lourdes  
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Giunta, Diego Hernan  
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Vazquez, Fernando Javier  
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Ferreyro, Bruno Leonel  
dc.date.available
2022-09-26T19:24:30Z  
dc.date.issued
2020-12  
dc.identifier.citation
Maritano Furcada, Joaquín; Castro, Horacio Matías; de Vito, Eduardo; Grande Ratti, María Florencia; Posadas Martinez, Maria Lourdes; et al.; Diagnosis of pulmonary embolism in patients with acute exacerbations of chronic obstructive pulmonary disease: a cross-sectional study; Wiley Blackwell Publishing, Inc; Clinical Respiratory Journal; 14; 12; 12-2020; 1-17  
dc.identifier.issn
1752-6981  
dc.identifier.uri
http://hdl.handle.net/11336/170498  
dc.description.abstract
Introduction: Pulmonary embolism (PE) remains a frequent complication in patients with chronic obstructive pulmonary disease (COPD). It is unclear that the extent to which the traditional risk stratifying scores for PE are accurate in this population. Methods: Cross-sectional study of adult patients with COPD and suspected PE included in an Institutional Registry of Thromboembolic Disease at a tertiary teaching hospital in the city of Buenos Aires, Argentina. We estimated the area under the receiver operating characteristic curves (AU-ROC), sensitivity and specificity of the Wells and Geneva scores using a positive computed tomography angiography as the gold standard for PE. We also estimated the sensitivity and specificity for the presence of isolated worsening of dyspnea at presentation, without other cardinal symptoms of acute exacerbation of COPD. Results: A total of 168 patients were included, of which 22% had confirmed PE. The AUC was 0.66 (95% CI 0.56-0.76) and 0.56 (95% CI 0.45-0.67) for the Wells and Geneva, respectively. Considering the most widely used cutoff points, the sensitivity and specificity were 24% and 90% for the Wells and 59% and 43% for the Geneva score, respectively. Isolated worsening of dyspnea on presentation had a sensitivity of 92% and specificity of 37%. Conclusions: Both Wells and Geneva scores exhibit poor diagnostic accuracy for the diagnosis of PE in patients with COPD. The presence of isolated worsening of dyspnea on presentation could be an easy to identify criteria for the initial triage in this population. Further validation of our findings remains warranted.  
dc.format
application/pdf  
dc.language.iso
eng  
dc.publisher
Wiley Blackwell Publishing, Inc  
dc.rights
info:eu-repo/semantics/openAccess  
dc.rights.uri
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/  
dc.subject
CHRONIC OBSTRUCTIVE PULMONARY DISEASE  
dc.subject
PULMONARY EMBOLISM  
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Sistemas Cardíaco y Cardiovascular  
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Medicina Clínica  
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CIENCIAS MÉDICAS Y DE LA SALUD  
dc.title
Diagnosis of pulmonary embolism in patients with acute exacerbations of chronic obstructive pulmonary disease: a cross-sectional study  
dc.type
info:eu-repo/semantics/article  
dc.type
info:ar-repo/semantics/artículo  
dc.type
info:eu-repo/semantics/publishedVersion  
dc.date.updated
2022-09-23T15:41:53Z  
dc.journal.volume
14  
dc.journal.number
12  
dc.journal.pagination
1-17  
dc.journal.pais
Reino Unido  
dc.journal.ciudad
Londres  
dc.description.fil
Fil: Maritano Furcada, Joaquín. Hospital Italiano; Argentina  
dc.description.fil
Fil: Castro, Horacio Matías. Hospital Italiano; Argentina  
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Fil: de Vito, Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina  
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Fil: Grande Ratti, María Florencia. Hospital Italiano; Argentina  
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Fil: Posadas Martinez, Maria Lourdes. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Hospital Italiano; Argentina  
dc.description.fil
Fil: Giunta, Diego Hernan. Hospital Italiano; Argentina  
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Fil: Vazquez, Fernando Javier. Hospital Italiano; Argentina  
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Fil: Ferreyro, Bruno Leonel. Hospital Italiano; Argentina. University of Toronto; Canadá  
dc.journal.title
Clinical Respiratory Journal  
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/url/https://onlinelibrary.wiley.com/doi/abs/10.1111/crj.13257  
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/doi/https://doi.org/10.1111/crj.13257