Performance du score de probabilité à 4 niveaux 4PEPS pour le diagnostic de l'embolie pulmonaire dans une population d'Afrique subsaharienne : données du Registre des Embolies Pulmonaires du Centre Hospitalier Universitaire de Bogodogo, Burkina Faso

IF 0.3 Q4 Medicine

Annales de cardiologie et d'angeiologie Pub Date : 2024-09-23 DOI:10.1016/j.ancard.2024.101798

Taryètba André Arthur Seghda , Temoua Dan Naibé , Yirtièrou Eric Dabiré , Martin Wendlassida Nacanabo , Sandrine Damoué Seghda , Djième Claudine Dah , Abouga Loya Mireille , Nobila Valentin Yaméogo , Georges R.C Millogo , Anna Tall Thiam , Laurence Flork , André K Samadoulougou , Patrice Zabsonré

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引用次数: 0

Abstract

Objective

To evaluate the performance of the 4PEPS score in the diagnosis of pulmonary embolism at the University Hospital of Bogodogo from January 1, 2021 to July 31, 2023.

Methodology

This was a cross-sectional descriptive and analytical diagnostic study, running from January 1, 2021 to July 31, 2023. It took place in the infectious and tropical diseases departments, including a pneumology unit and a cardiology unit, of the Bogodogo University Hospital. Patients of both sexes with suspected pulmonary embolism who had undergone CT scan were included. The 4PEPS score was calculated and dichotomized into probable and improbable. It thus constituted the diagnostic test. CT scan was the gold standard. The accuracy of the diagnostic test was judged by the area under the ROC curve. An area under the curve between 0.70 and 1 would mean that the score was moderately informative to perfect.

Results

Our study included 472 patients with suspected pulmonary embolism out of a total population of 1228 patients. Hospital prevalence was 21.7%. The mean age of patients was 54.3 years. Females accounted for 52.1% of cases, with a sex ratio of 0.93. The prevalence of pulmonary embolism in the different probability levels of the 4PEPS score was 13.3% for the very low level, 11.7% for the low level, 84.6% for the intermediate level and 93.3% for the high level. Sensitivity and specificity were 92.1% and 86.82% respectively. The positive and negative predictive values were 90.1% and 89.4% respectively. The area under the ROC curve was 0.91.

Conclusion

In our study, the 4PEPS score showed good negative and positive predictive values. The use of this score will enable practitioners faced with diagnostic difficulties to make therapeutic decisions, reducing inappropriate prescriptions for thoracic angioscan.

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撒哈拉以南非洲人群肺栓塞诊断4级概率评分4PEPS的性能：布基纳法索博戈多戈大学医院肺栓塞登记处的数据

目的评估 2021 年 1 月 1 日至 2023 年 7 月 31 日期间博戈多戈大学医院在诊断肺栓塞时使用 4PEPS 评分的效果。方法这是一项横断面描述性和分析性诊断研究，研究时间为 2021 年 1 月 1 日至 2023 年 7 月 31 日。研究在博戈多戈大学医院的传染病和热带病科进行，其中包括肺病科和心脏病科。研究对象包括接受过 CT 扫描的疑似肺栓塞男女患者。计算出 4PEPS 评分，并将其分为可能和不可能两种。这就是诊断测试。CT 扫描是金标准。诊断测试的准确性由 ROC 曲线下的面积来判断。曲线下的面积在 0.70 和 1 之间，表示该评分具有中等至完美的信息量。医院发病率为 21.7%。患者的平均年龄为 54.3 岁。女性占 52.1%，性别比为 0.93。在 4PEPS 评分的不同概率级别中，肺栓塞的发病率分别为：极低级别 13.3%，低级别 11.7%，中级级别 84.6%，高级别的 93.3%。敏感性和特异性分别为 92.1%和 86.82%。阳性预测值为 90.1%，阴性预测值为 89.4%。结论在我们的研究中，4PEPS 评分显示出良好的阴性和阳性预测值。使用该评分可使面临诊断困难的从业人员做出治疗决定，减少胸腔血管扫描的不适当处方。

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来源期刊

Annales de cardiologie et d'angeiologie 医学-外周血管病

CiteScore

0.60

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Organe scientifique de référence fondé en 1951, les Annales de cardiologie et d''angéiologie abordent tous les domaines qui intéressent quotidiennement les cardiologues et les angéiologues praticiens : neurologie et radiologie vasculaires, hémostase, diabétologie, médecine interne, épidémiologie et prévention. Les Annales de cardiologie et d''angéiologie sont indexées aux grandes bases de données et publient rapidement, et en conformité avec les normes internationales de publication scientifique, des articles en français sur la pathologie cardiaque.