LUNG ALERT
Detecting PE in COPD
Specialist Registrar, Queen Elizabeth Hospital, Kings Lynn, UK; drvinodaiyappan@doctors.org.uk
| The first 150 words of the full text of this article appear below. |
Monreal M, Munoz-Torrero JF, Naraine VS, et al. Pulmonary embolism in patients with chronic obstructive pulmonary disease or congestive heart failure. Am J Med 2006;119:851–8.[CrossRef][Medline]
Pulmonary embolism (PE) is a difficult diagnosis to make or exclude and there have been various pretest probability scoring systems developed to aid the clinician in this area. However, these scoring systems do not take into account underlying cardiopulmonary abnormalities. This interesting study by Monreal et al looked at the diagnosis of PE in patients with congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD).
From a total of 4444 patients with proven PE enrolled in a registry, 14% had COPD and 9.5% had CHF. Using the Geneva scoring system, a lower percentage of patients with PE with COPD or CHF fell into the low pretest probability category (RR 0.82, 95% CI 0.66 to 1.02 and RR
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