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

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...

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Autores principales:	Kara E. Hennelly, Angela M. Ellison, Mark I. Neuman, Jeffrey A. Kline
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2020
Materias:	Diseases of the blood and blood-forming organs RC633-647.5
Acceso en línea:	https://doaj.org/article/bb97115853c840ca8384755680f28cb0
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spelling	oai:doaj.org-article:bb97115853c840ca8384755680f28cb02021-11-15T06:10:44ZClinical variables that increase the probability of pulmonary embolism diagnosis in symptomatic children2475-037910.1002/rth2.12265https://doaj.org/article/bb97115853c840ca8384755680f28cb02020-01-01T00:00:00Zhttps://doi.org/10.1002/rth2.12265https://doaj.org/toc/2475-0379Abstract 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.Kara E. HennellyAngela M. EllisonMark I. NeumanJeffrey A. KlineWileyarticleDiseases of the blood and blood-forming organsRC633-647.5ENResearch and Practice in Thrombosis and Haemostasis, Vol 4, Iss 1, Pp 124-130 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the blood and blood-forming organs RC633-647.5
spellingShingle	Diseases of the blood and blood-forming organs RC633-647.5 Kara E. Hennelly Angela M. Ellison Mark I. Neuman Jeffrey A. Kline Clinical variables that increase the probability of pulmonary embolism diagnosis in symptomatic children
description	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.
format	article
author	Kara E. Hennelly Angela M. Ellison Mark I. Neuman Jeffrey A. Kline
author_facet	Kara E. Hennelly Angela M. Ellison Mark I. Neuman Jeffrey A. Kline
author_sort	Kara E. Hennelly
title	Clinical variables that increase the probability of pulmonary embolism diagnosis in symptomatic children
title_short	Clinical variables that increase the probability of pulmonary embolism diagnosis in symptomatic children
title_full	Clinical variables that increase the probability of pulmonary embolism diagnosis in symptomatic children
title_fullStr	Clinical variables that increase the probability of pulmonary embolism diagnosis in symptomatic children
title_full_unstemmed	Clinical variables that increase the probability of pulmonary embolism diagnosis in symptomatic children
title_sort	clinical variables that increase the probability of pulmonary embolism diagnosis in symptomatic children
publisher	Wiley
publishDate	2020
url	https://doaj.org/article/bb97115853c840ca8384755680f28cb0
work_keys_str_mv	AT karaehennelly clinicalvariablesthatincreasetheprobabilityofpulmonaryembolismdiagnosisinsymptomaticchildren AT angelamellison clinicalvariablesthatincreasetheprobabilityofpulmonaryembolismdiagnosisinsymptomaticchildren AT markineuman clinicalvariablesthatincreasetheprobabilityofpulmonaryembolismdiagnosisinsymptomaticchildren AT jeffreyakline clinicalvariablesthatincreasetheprobabilityofpulmonaryembolismdiagnosisinsymptomaticchildren
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Clinical variables that increase the probability of pulmonary embolism diagnosis in symptomatic children

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