The retrospective evaluation of patients with pulmonary thromboembolism that were hospitalised between the years of 2000-2005

H. SUMMARYThe Retrospective Evaluation of Patients With Pulmonary Thromoembolism ThatWere Hospitalised Between The Years of 2000- 2005Introduction: Pulmonary thromboembolism (PTE) is a common disease but there is stilsome difficulties in its diagnosis and it has a high mortality. However this mortality can bereduced by the initiation of treatment. The first step in the diagnosis of PTE is theevaulation of clinical probability.Aim: In this study we aimed to evaluate the diagnostic algorithm of PTE that is used inour clinic and to the determine the sensitivity of diagnostic methods and also the errors inpractice. By these evaluations, we decided to develop a new diagnostic algorithm.Material and Method: 108 patients with PTE were enrolled in this study which weretreated between January 2000 and December 2005. Pretreatment clinical and laboratorycharacteristics of these patients were evaluated. Clinical probabilities were determinedaccording to ?Hyers Clinical Score System?. Clinical probability was also determinedaccording to ?Wicki and Wells Clinical Score Systems?, by using datas obtained frommedical reports.Results: In the study population, there was 54 (50%) males and 54 (50%) females with themean ages of 47.9 ± 17.2 for males, 50.5 ± 18.4 for females. The mean hospitalizationperiod was 14.7 days, the mean symptom period was 3.5 days, the mean diagnostic timewas 5.59 days, statistically significant differences were observed between these threevalues of intermediate and high clinical probability groups (p<0.05). It was found that ourD-Dimer method can eliminate only low clinical probability because D-Dimer was foundnormal in 5 patients with intermediate clinical probability. Low clinical probabilityaccording to Wells, in combinaton with abnormal D-Dimer levels, did not excluded thepatients with PTE. Therefore the evaluation of D-Dimer together with Wells were foundvaluable. The mean D-Dimer level was significantly high (p<0.05) in patients of massivepulmonary thromboembolism.Among the etiology of Herediter Thrombophilia; gene mutation of Factor 5Leiden, gene mutation of prothrombin G20210A and deficiency of MethyltetrahydrofolateReductase were found to be positive as 1.1%, 12.5% and 33.3% respectively.The harmony between the clinical score systems were compared. The harmonieswere significant between Wicki-Wells ( r= 0.231 p<0.01) and Wells-Hyers ( r= 0.285p<0.01). The harmony was not significant between Wicki and Hyers (r: 0.127 p>0.05). Thehighest harmony was determined between Wells and Hyers .Conclusion: It was determined that ?Wells Clinical Score System? may be an alternativeto Hyers system that was used in our clinic. It was also found there was an associationbetween the high D-Dimer levels and massive pulmonary embolism and it may beconsidered among predictive markers of it.100