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Clinical variables that increase the probability of pulmonary embolism diagnosis in symptomatic children

Authors :
Kara E. Hennelly
Angela M. Ellison
Mark I. Neuman
Jeffrey A. Kline
Source :
Research and Practice in Thrombosis and Haemostasis, Vol 4, Iss 1, Pp 124-130 (2020)
Publication Year :
2020
Publisher :
Elsevier, 2020.

Abstract

Abstract Background Pulmonary embolism (PE) in children carries a significant morbidity and mortality. We examined previously described factors in 2 cohorts of children tested for PE and identified novel factors. Methods We combined data from 2 retrospective cohorts. Patients up to age 21 years were included who underwent imaging or D‐dimer testing for PE, with positive radiologic testing being the gold standard. Combined predictor variables were examined by univariate analysis and then forward stepwise multivariable logistic regression. Results The combined data set yielded 1103 patients with 42 unique predictor variables, and 93 PE‐positive patients (8.4%), with a median age of 16 years. Univariate analysis retained 17 variables, and multivariable logistic regression found 9 significant variables with increased probability of PE diagnosis: age‐adjusted tachycardia, tachypnea, hypoxia, unilateral limb swelling, trauma/surgery requiring hospitalization in previous 4 weeks, prior thromboembolism, cancer, anemia, and leukocytosis. Conclusion This combined data set of children with suspected PE discovered factors that may contribute to a diagnosis of PE: hypoxia, unilateral limb swelling, trauma/surgery requiring hospitalization in previous 4 weeks, prior thromboembolism, and cancer, age‐adjusted tachycardia, tachypnea, anemia, and leukocytosis. Prospective testing is needed to determine which criteria should be used to initiate diagnostic testing for PE in children.

Details

Language :
English
ISSN :
24750379
Volume :
4
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Research and Practice in Thrombosis and Haemostasis
Publication Type :
Academic Journal
Accession number :
edsdoj.bb97115853c840ca8384755680f28cb0
Document Type :
article
Full Text :
https://doi.org/10.1002/rth2.12265