Diagnostic performance of YEARS criteria combined with point-of-care lung and venous ultrasound in suspected pulmonary embolism
Clinical prediction rules and bedside lung and venous ultrasound are frequently used in the diagnostic workup of suspected pulmonary embolism (PE). The possibility of improving the YEARS algorithm by integrating ultrasound has never been investigated. We analyzed data from a previous study involvin...
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PAGEPress Publications
2025-05-01
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| Series: | Emergency Care Journal |
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| author | Chiara Gigli Giovanni Volpicelli Antonio Annovi Ángel Sánchez Garrido-Lestache Maria Cristina Vedovati Cecilia Becattini Simone Vanni Peiman Nazerian |
| author_facet | Chiara Gigli Giovanni Volpicelli Antonio Annovi Ángel Sánchez Garrido-Lestache Maria Cristina Vedovati Cecilia Becattini Simone Vanni Peiman Nazerian |
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Clinical prediction rules and bedside lung and venous ultrasound are frequently used in the diagnostic workup of suspected pulmonary embolism (PE). The possibility of improving the YEARS algorithm by integrating ultrasound has never been investigated. We analyzed data from a previous study involving a total of 446 outpatients with suspected PE. Signs of deep vein thrombosis (DVT) on venous ultrasound and signs of pulmonary infarctions or alternative diagnoses on lung ultrasound were used to recalculate two items of the YEARSc: signs and symptoms of DVT and alternative diagnosis less likely than PE. Diagnostic performance of ultrasound-enhanced YEARS criteria (US-YEARSc) and YEARSc were compared after final diagnosis. 446 patients were included, PE was confirmed in 125 (28%). US-YEARSc performed significantly better than YEARSc (sensitivity 82.4% vs 64.8%, p=0.001; specificity 81% vs 48.6%, p < 0.001). US-YEARSc plus negative d-dimer compared to YEARSc and negative d-dimer showed an inferior failure rate (5.9% vs 8.9%, p=0.25) and a superior efficiency (51.8% vs 48.2%, p=0.31), without reaching statistical significance. US-YEARSc perform better than YEARSc in the diagnosis of PE.
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| format | Article |
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| institution | OA Journals |
| issn | 2282-2054 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | PAGEPress Publications |
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| spelling | doaj-art-2f37816658ae47689e8bfadf86bf055b2025-08-20T01:49:03ZengPAGEPress PublicationsEmergency Care Journal2282-20542025-05-0110.4081/ecj.2025.13779 Diagnostic performance of YEARS criteria combined with point-of-care lung and venous ultrasound in suspected pulmonary embolismChiara Gigli0Giovanni Volpicelli1Antonio Annovi2Ángel Sánchez Garrido-Lestache3Maria Cristina Vedovati4Cecilia Becattini5Simone Vanni6Peiman Nazerian7Emergency Department, Careggi University Hospital, FirenzeDepartment of Medical and Surgical Science, Magna Graecia University, CatanzaroEmergency Department, Careggi University Hospital, FirenzeEmergency Department, University Hospital Complex of Albacete, AlbaceteInternal, Vascular and Emergency Medicine - Stroke Unit, Department of Medicine and Surgery, University of Perugia, PerugiaInternal, Vascular and Emergency Medicine - Stroke Unit, Department of Medicine and Surgery, University of Perugia, PerugiaDipartimento di Medicina Sperimentale e Clinica, Università degli studi di Firenze, FlorenceEmergency Department, Careggi University Hospital, Firenze Clinical prediction rules and bedside lung and venous ultrasound are frequently used in the diagnostic workup of suspected pulmonary embolism (PE). The possibility of improving the YEARS algorithm by integrating ultrasound has never been investigated. We analyzed data from a previous study involving a total of 446 outpatients with suspected PE. Signs of deep vein thrombosis (DVT) on venous ultrasound and signs of pulmonary infarctions or alternative diagnoses on lung ultrasound were used to recalculate two items of the YEARSc: signs and symptoms of DVT and alternative diagnosis less likely than PE. Diagnostic performance of ultrasound-enhanced YEARS criteria (US-YEARSc) and YEARSc were compared after final diagnosis. 446 patients were included, PE was confirmed in 125 (28%). US-YEARSc performed significantly better than YEARSc (sensitivity 82.4% vs 64.8%, p=0.001; specificity 81% vs 48.6%, p < 0.001). US-YEARSc plus negative d-dimer compared to YEARSc and negative d-dimer showed an inferior failure rate (5.9% vs 8.9%, p=0.25) and a superior efficiency (51.8% vs 48.2%, p=0.31), without reaching statistical significance. US-YEARSc perform better than YEARSc in the diagnosis of PE. https://www.pagepressjournals.org/ecj/article/view/13779Lung ultrasoundvenous ultrasoundpulmonary embolismdeep vein thrombosis |
| spellingShingle | Chiara Gigli Giovanni Volpicelli Antonio Annovi Ángel Sánchez Garrido-Lestache Maria Cristina Vedovati Cecilia Becattini Simone Vanni Peiman Nazerian Diagnostic performance of YEARS criteria combined with point-of-care lung and venous ultrasound in suspected pulmonary embolism Emergency Care Journal Lung ultrasound venous ultrasound pulmonary embolism deep vein thrombosis |
| title | Diagnostic performance of YEARS criteria combined with point-of-care lung and venous ultrasound in suspected pulmonary embolism |
| title_full | Diagnostic performance of YEARS criteria combined with point-of-care lung and venous ultrasound in suspected pulmonary embolism |
| title_fullStr | Diagnostic performance of YEARS criteria combined with point-of-care lung and venous ultrasound in suspected pulmonary embolism |
| title_full_unstemmed | Diagnostic performance of YEARS criteria combined with point-of-care lung and venous ultrasound in suspected pulmonary embolism |
| title_short | Diagnostic performance of YEARS criteria combined with point-of-care lung and venous ultrasound in suspected pulmonary embolism |
| title_sort | diagnostic performance of years criteria combined with point of care lung and venous ultrasound in suspected pulmonary embolism |
| topic | Lung ultrasound venous ultrasound pulmonary embolism deep vein thrombosis |
| url | https://www.pagepressjournals.org/ecj/article/view/13779 |
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