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6 - 27 Patients with pulmonary thromboembolism
Gülçin Güngör Olçum, Sami Akbaş, Sema Basat
Objective: Clinical, laboratory and radiological findings play a major role for the diagnosis of Pulmonary Embolism. However, its diagnosis is usually challenging due to other clinical problems of patients. In this study; our aim is to determine the risk factors of patients, by evaluating their initial complaints, clinical and laboratory parameters.
Material and Method: In this study, we included 27 patients having the findings of pulmonary embolism applying to our clinic between the years 2010-2014. Risk factors at the diagnosis, symptoms, and radiological findings were retrospectively evaluated. Clinical prediction scores of all patients at the time of application was calculated by using Wells scoring system (Canadian score).
Results: The mean age of the patients were 74.56±11.63 and %25.9 were male whereas %74.1 were female. 29.6% of the cases were active smokers. The mean Wells score and D-dimer values were 3.57±1.7 and 2697.85±1648.26 respectively. The factors that leads to pulmonary embolism were surgery/immobilization in 48.1% and subclinical diagnosis of DVT in 55.6%. The frequent symptoms were dyspnea (59.3%) and palpitations (44.4%) and ın Physıcal examination the most common findings were tachypnea (66.7%) and pulmonary rales (48.1%). In the blood gases undertaken in room air alkaline PH that revealed hypoxia and hypercarbia were present. The most common pulmonary X ray fındıng was the elevated diaphragm (51.9%). Doppler Ultrasound was done in 48.1% of the patients and DVT findings was present in 46.15%. 11 (40.7%) cases underwent a ventilation perfusion scintigraphy and out of these 63.3% findings consistent with Pulmonary Embolism were present. In patients whom CT angiogram was done 48.1% revealed fındıngs of Pulmonary Embolism (PE).
Conclusion: In conclusion our study showed that ventilation perfusion scintigraphy, CT angiography and Venous Doppler ın DVT protocol were not done in 59.3%, 51.9%, 51.9% cases respectively. The elder age of the patients and systemic high risk comorbidities are thought to be the limiting factors that lead to non-application of the above tests. For this reason, clinical suspicion and assessment of probable risk factors is important for early diagnosis and rapid initiation of treatment for pulmonary embolism.
Keywords: Pulmoner emboli, wells skoru, pulmoner sintigrafi, BT Anjio
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