RT journal article
T1 Elderly Population with COVID-19 and the Accuracy of Clinical Scales and D-Dimer for Pulmonary Embolism: The OCTA-COVID Study
A1 Quezada‑Feijoo, Maribel
A1 Ramos, Mónica
A1 Lozano-Montoya, Isabel
A1 Sarro, Mónica
A1 Cabo Muiños, Verónica
A1 Ayala, Rocío
A1 Gómez-Pavón, Francisco J.
A1 Toro Cebada, Rocío
A2 Medicina
K1 pulmonary embolism
K1 Wells scale
K1 Geneva scale
K1 COVID-19
K1 older patients
AB Background: Elderly COVID-19 patients have a high risk of pulmonary embolism (PE),but factors that predict PE are unknown in this population. This study assessed the Wells andrevised Geneva scoring systems as predictors of PE and their relationships with D-dimer (DD) in thispopulation. Methods: This was a longitudinal, observational study that included patients  75 yearsold with COVID-19 and suspected PE. The performances of theWells score, revised Geneva scoreand DD levels were assessed. The combinations of the DD level and the clinical scales were evaluatedusing positive rules for higher specificity. Results: Among 305 patients included in the OCTA-COVIDstudy cohort, 50 had suspected PE based on computed tomography pulmonary arteriography (CTPA),and the prevalence was 5.6%. The frequencies of PE in the low-, intermediate- and high-probabilitycategories were 5.9%, 88.2% and 5.9% for the Geneva model and 35.3%, 58.8% and 5.9% for the Wellsmodel, respectively. The DD median was higher in the PE group (4.33 mg/L; interquartile range(IQR) 2.40–7.17) than in the no PE group (1.39 mg/L; IQR 1.01–2.75) (p < 0.001). The area under thecurve (AUC) for DD was 0.789 (0.652–0.927). After changing the cutoff point for DD to 4.33 mg/L,the specificity increased from 42.5% to 93.9%. Conclusions: The cutoff point DD > 4.33 mg/L hasan increased specificity, which can discriminate false positives. The addition of the DD and theclinical probability scales increases the specificity and negative predictive value, which helps to avoidunnecessary invasive tests in this population.
PB MDPI
SN 2077-0383
YR 2021
FD 2021-11
LK http://hdl.handle.net/10498/26240
UL http://hdl.handle.net/10498/26240
LA eng
DS Repositorio Institucional de la Universidad de Cádiz
RD 08-nov-2026