RT Journal Article
T1 Elderly Population with COVID-19 and the Accuracy of Clinical Scales and D-Dimer for Pulmonary Embolism: The OCTA-COVID Study
A1 Quezada-Feijoo, Maribel
A1 Ramos, Monica
A1 Lozano-Montoya, Isabel
A1 Sarro, Monica
A1 Muinos, Veronica Cabo
A1 Ayala, Rocio
A1 Gomez-Pavon, Francisco J.
A1 Toro, Rocio
K1 pulmonary embolism
K1 Wells scale
K1 Geneva scale
K1 COVID-19
K1 older patients
AB Background: Elderly COVID-19 patients have a high risk of pulmonary embolism (PE), but factors that predict PE are unknown in this population. This study assessed the Wells and revised Geneva scoring systems as predictors of PE and their relationships with D-dimer (DD) in this population.Methods: This was a longitudinal, observational study that included patients ≥75 years old with COVID-19 and suspected PE. The performances of the Wells score, revised Geneva score and DD levels were assessed. The combinations of the DD level and the clinical scales were evaluated using positive rules for higher specificity.Results: Among 305 patients included in the OCTA-COVID study cohort, 50 had suspected PE based on computed tomography pulmonary arteriography (CTPA), and the prevalence was 5.6%. The frequencies of PE in the low-, intermediate- and high-probability categories were 5.9%, 88.2% and 5.9% for the Geneva model and 35.3%, 58.8% and 5.9% for the Wells model, respectively. The DD median was higher in the PE group (4.33 mg/L; interquartile range (IQR) 2.40-7.17) than in the no PE group (1.39 mg/L; IQR 1.01-2.75) (p < 0.001). The area under the curve (AUC) for DD was 0.789 (0.652-0.927). After changing the cutoff point for DD to 4.33 mg/L, the specificity increased from 42.5% to 93.9%.Conclusions: The cutoff point DD > 4.33 mg/L has an increased specificity, which can discriminate false positives. The addition of the DD and the clinical probability scales increases the specificity and negative predictive value, which helps to avoid unnecessary invasive tests in this population.
PB Mdpi
SN 2077-0383
YR 2021
FD 2021-11-20
LK https://hdl.handle.net/10668/25241
UL https://hdl.handle.net/10668/25241
LA en
NO Quezada-Feijoo M, Ramos M, Lozano-Montoya I, Sarro M, Muinos VC, Ayala R, et al. Elderly Population with COVID-19 and the Accuracy of Clinical Scales and D-Dimer for Pulmonary Embolism: The OCTA-COVID Study. J Clin Med. 2021;10(22):5433. Published 2021 Nov 20.
NO This work was partially supported by grants (to M.Q.-F., M.R. and R.T.) from the “New announcement for extraordinary initiative fund UAX-Santander COVID-19”, under ID 1.011.103, Universidad Alfonso X el Sabio. This study was also supported by the Fundación Pública Andaluza Progreso y Salud para la Financiación, co-financed by the European Regional Development Fund (ERDF) (PI-0048-2017 and PI0033_ 2019), and by a grant from the Spanish Society of Cardiology (SEC) for Basic Research (0011-2019).
DS RISalud
RD Sep 16, 2025