PreprintArticleVersion 1This version is not peer-reviewed
Comparative Analysis of the Impact of Severe Acute Respiratory Syndrome Coronavirus 2 Infection on the Performance of Clinical Decision‐Making Algorithms for Pulmonary Embolism
Version 1
: Received: 18 October 2024 / Approved: 18 October 2024 / Online: 18 October 2024 (16:24:38 CEST)
How to cite:
Eksioglu, M.; Azapoglu Kaymak, B.; Elhan, A. H.; Cimilli Ozturk, T. Comparative Analysis of the Impact of Severe Acute Respiratory Syndrome Coronavirus 2 Infection on the Performance of Clinical Decision‐Making Algorithms for Pulmonary Embolism. Preprints2024, 2024101514. https://doi.org/10.20944/preprints202410.1514.v1
Eksioglu, M.; Azapoglu Kaymak, B.; Elhan, A. H.; Cimilli Ozturk, T. Comparative Analysis of the Impact of Severe Acute Respiratory Syndrome Coronavirus 2 Infection on the Performance of Clinical Decision‐Making Algorithms for Pulmonary Embolism. Preprints 2024, 2024101514. https://doi.org/10.20944/preprints202410.1514.v1
Eksioglu, M.; Azapoglu Kaymak, B.; Elhan, A. H.; Cimilli Ozturk, T. Comparative Analysis of the Impact of Severe Acute Respiratory Syndrome Coronavirus 2 Infection on the Performance of Clinical Decision‐Making Algorithms for Pulmonary Embolism. Preprints2024, 2024101514. https://doi.org/10.20944/preprints202410.1514.v1
APA Style
Eksioglu, M., Azapoglu Kaymak, B., Elhan, A. H., & Cimilli Ozturk, T. (2024). Comparative Analysis of the Impact of Severe Acute Respiratory Syndrome Coronavirus 2 Infection on the Performance of Clinical Decision‐Making Algorithms for Pulmonary Embolism. Preprints. https://doi.org/10.20944/preprints202410.1514.v1
Chicago/Turabian Style
Eksioglu, M., Atilla Halil Elhan and Tuba Cimilli Ozturk. 2024 "Comparative Analysis of the Impact of Severe Acute Respiratory Syndrome Coronavirus 2 Infection on the Performance of Clinical Decision‐Making Algorithms for Pulmonary Embolism" Preprints. https://doi.org/10.20944/preprints202410.1514.v1
Abstract
Background/Objectives: This study aimed to compare the diagnostic accuracy of the Wells and Geneva scores, used with a 500 ng/mL D-dimer cutoff, along with the age-adjusted D-dimer (AADD), YEARS, and PEGeD algorithms in patients with and without COVID-19. The performance of various D-dimer thresholds was also evaluated.
Methods: This retrospective study included patients who presented to the emergency department and underwent computed tomography pulmonary angiography (CTPA) for suspected pulmonary embolism (PE). The diagnostic performance of clinical prediction algorithms was compared between two groups.
Results: We analyzed data from 1423 patients; PE diagnosis and COVID-19 positivity rates were 7.3% and 69.9%, respectively. In patients with COVID-19, the Wells score with a 500 ng/mL D-dimer threshold exhibited 97.22% sensitivity (95% CI: 80.53–100.00) and 4.99% specificity (95% CI: 3.58–6.39). Using AADD increased the specificity to 7.81% (95% CI: 6.08–9.54) while maintaining sensitivity at 97.22% (95% CI: 93.43–100.00); similar results were observed for the Geneva score. The YEARS algorithm exhibited 86.11% sensitivity (95% CI: 78.12–94.10) and 32.75% specificity (95% CI: 29.73–35.78), whereas the PEGeD algorithm exhibited 86.11% sensitivity (95% CI: 78.12–94.10) and 34.06% specificity (95% CI: 31.00–37.12). The YEARS and PEGeD algorithms demonstrated better performance in patients with COVID-19 in terms of specificity and accuracy.
Conclusion: COVID-19 infection did not significantly affect the diagnostic performances of the clinical algorithms for PE. YEARS and PEGeD performed better in patients with COVID-19, making them preferable. Higher D-dimer thresholds improved specificity but increased the risk of missed PE diagnoses.
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
