Sistemas de valoración clínica en el diagnóstico del tromboembolismo pulmonar (TEP)
Clinical evaluation systems for diagnosing pulmonary thromboembolism
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Plaza, J. Giner, J. Gómez, P. Casan, J. Sanchis" "autores" => array:5 [ 0 => array:2 [ "nombre" => "V." "apellidos" => "Plaza" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Giner" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Gómez" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Casan" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Sanchis" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615306384?idApp=UINPBA00003Z" "url" => "/03002896/0000003300000003/v1_201506200427/S0300289615306384/v1_201506200427/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "Sistemas de valoración clínica en el diagnóstico del tromboembolismo pulmonar (TEP)" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "118" "paginaFinal" => "123" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "R. Otero-Candelera, A. Cayuela Domínguez, M. Arenas, A. Segado Soriano, E. Barrot Cortés, A. Verano Rodríguez" "autores" => array:6 [ 0 => array:3 [ "nombre" => "R." "apellidos" => "Otero-Candelera" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "A." "apellidos" => "Cayuela Domínguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "M." "apellidos" => "Arenas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "A." "apellidos" => "Segado Soriano" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "E." "apellidos" => "Barrot Cortés" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "A." "apellidos" => "Verano Rodríguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicios de Neumología, Hospital Universitario Virgen del Rocío. Sevilla" "etiqueta" => "*" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicios de Epidemiología Clínica. Hospital Universitario Virgen del Rocío. Sevilla" "etiqueta" => "**" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Correspondencia: Castillo de Marchenilla, 5, núcleo 2, l.° A. 41013 Sevilla." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Clinical evaluation systems for diagnosing pulmonary thromboembolism" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1996-02-13" "fechaAceptado" => "1996-07-16" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec545600" "palabras" => array:3 [ 0 => "Embolia pulmonar" 1 => "Perfil clínico del TEP" 2 => "Diagnóstico del TEP" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec545601" "palabras" => array:2 [ 0 => "Pulmonary embolism" 1 => "Diagnosis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Nos propusimos desarrollar en nuestro medio los dos sistemas de valoración de la presencia de TEP a partir de la evaluación clínica del paciente (cuestionario estandarizado y modelos multivariantes).</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Desde septiembre de 1993 hasta noviembre de 1994 se recogieron los datos (historia clínica, exploración, pruebas complementarias) de los pacientes ingresados en nuestra planta de hospitalización por sospecha de TEP. Las <span class="elsevierStyleItalic">odds ratio</span> calculadas de cada una de las variables recogidas se utilizaron como pesos para determinar la pertenencia o no al grupo de riesgo de TEP. Además, se realizó un análisis de regresión logística múltiple. El rendimiento de los dos sistemas de valoración creados (sistemas de pesos y modelo logístico) se estudió mediante la construcción de las curvas ROC. Fueron ingresados 82 pacientes: 40 mujeres y 42 varones con una edad media de 60,94<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>14,39 años. Mediante el cuestionario se llegó a obtener una sensibilidad del 88%, una especificidad del 75%, un valor predictivo positivo del 94% y un valor predictivo negativo del 60%. Con la aplicación de un modelo de regresión logística, se obtuvo una sensibilidad del 96,3% para el diagnóstico de TEP, incluyendo las siguientes variables: sexo femenino, inmovilización por causa médica, presencia clínica de trombosis venosa profunda (TVP) en miembros inferiores y aparición de disnea injustificada. Comparando ambos métodos ninguno de ambos sistemas apareció claramente superior al otro en la valoración clínica para el diagnóstico de TEP.</p></span>" ] "en" => array:1 [ "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We proposed developing two symptom-based systems for assessing the presence of pulmonary thromboembolism (TEP) in our practice, using a standardized questionnaire and multivariate models.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Data were collected from September 1993 through November 1994 (case reports, physical examination findings and complementary test results) of patients admitted to our ward with a suspicion of TEP. The calculated odds ratio for each of the variables recorded were used as weights to determine their relevance or not for the group at risk for TEP. The yield of the two systems developed (a weights system and a logistical model) were studied by plotting ROC curves. Eighty-two patients (40 women and 42 men, mean age 60.94<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>14.39 years) were admitted. The questionnaire had a sensitivity of 88% and a specificity of 75%, a positive predictive value of 94% and a negative predictive value of 60%. The logistical regression model had a sensitivity of 96.3% for a diagnosis of TEP with inclusion of the following variables: female sex, disease-related immobility, presence of deep venous thrombosis (DVT) in the lower extremities and the appearance of unexplained dyspnea. Neither system was clearly superior to the other for arriving at a clinical diagnosis of TEP.</p></span>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:20 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Factors contribuiting to incorrect diagnosis of pulmonary embolic disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "B. Modan" 1 => "E. Sharon" 2 => "N. Jelin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "1972" "volumen" => "62" "paginaInicial" => "388" "paginaFinal" => "393" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5077995" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 2 | 7 |
| 2024 October | 51 | 10 | 61 |
| 2024 September | 46 | 22 | 68 |
| 2024 August | 51 | 26 | 77 |
| 2024 July | 43 | 29 | 72 |
| 2024 June | 55 | 26 | 81 |
| 2024 May | 50 | 28 | 78 |
| 2024 April | 31 | 17 | 48 |
| 2024 March | 33 | 27 | 60 |
| 2024 February | 34 | 37 | 71 |
| 2024 January | 0 | 4 | 4 |
| 2023 December | 0 | 2 | 2 |
| 2023 November | 0 | 2 | 2 |
| 2023 October | 0 | 4 | 4 |
| 2023 August | 0 | 1 | 1 |
| 2023 July | 0 | 16 | 16 |
| 2023 June | 0 | 1 | 1 |
| 2023 April | 20 | 1 | 21 |
| 2023 March | 4 | 4 | 8 |
| 2023 February | 32 | 20 | 52 |
| 2023 January | 29 | 27 | 56 |
| 2022 December | 34 | 25 | 59 |
| 2022 November | 45 | 20 | 65 |
| 2022 October | 27 | 35 | 62 |
| 2022 September | 24 | 23 | 47 |
| 2022 August | 32 | 42 | 74 |
| 2022 July | 20 | 41 | 61 |
| 2022 June | 23 | 30 | 53 |
| 2022 May | 22 | 38 | 60 |
| 2022 April | 34 | 28 | 62 |
| 2022 March | 26 | 36 | 62 |
| 2022 February | 26 | 34 | 60 |
| 2022 January | 24 | 52 | 76 |
| 2021 December | 12 | 45 | 57 |
| 2021 November | 20 | 39 | 59 |
| 2021 October | 61 | 39 | 100 |
| 2021 September | 27 | 39 | 66 |
| 2021 August | 20 | 33 | 53 |
| 2021 July | 18 | 23 | 41 |
| 2021 June | 24 | 27 | 51 |
| 2021 May | 23 | 27 | 50 |
| 2021 April | 29 | 72 | 101 |
| 2021 March | 43 | 33 | 76 |
| 2021 February | 46 | 18 | 64 |
| 2021 January | 30 | 25 | 55 |
| 2020 December | 25 | 18 | 43 |
| 2020 November | 10 | 22 | 32 |
| 2020 October | 13 | 13 | 26 |
| 2020 September | 7 | 8 | 15 |
| 2020 August | 20 | 18 | 38 |
| 2020 July | 24 | 13 | 37 |
| 2020 June | 15 | 10 | 25 |
| 2020 May | 23 | 15 | 38 |
| 2020 April | 21 | 37 | 58 |
| 2020 March | 16 | 32 | 48 |
| 2020 February | 31 | 20 | 51 |
| 2020 January | 37 | 28 | 65 |
| 2019 December | 29 | 29 | 58 |
| 2019 November | 13 | 10 | 23 |
| 2019 October | 19 | 22 | 41 |
| 2019 September | 20 | 27 | 47 |
| 2019 August | 19 | 11 | 30 |
| 2019 July | 16 | 34 | 50 |
| 2019 June | 24 | 18 | 42 |
| 2019 May | 44 | 33 | 77 |
| 2019 April | 68 | 48 | 116 |
| 2019 March | 21 | 21 | 42 |
| 2019 February | 11 | 19 | 30 |
| 2019 January | 10 | 24 | 34 |
| 2018 December | 11 | 31 | 42 |
| 2018 November | 24 | 31 | 55 |
| 2018 October | 24 | 22 | 46 |
| 2018 September | 21 | 7 | 28 |
| 2018 May | 7 | 3 | 10 |
| 2018 April | 12 | 21 | 33 |
| 2018 March | 7 | 11 | 18 |
| 2018 February | 10 | 13 | 23 |
| 2018 January | 11 | 9 | 20 |
| 2017 December | 8 | 17 | 25 |
| 2017 November | 7 | 8 | 15 |
| 2017 October | 9 | 16 | 25 |
| 2017 September | 4 | 11 | 15 |
| 2017 August | 10 | 16 | 26 |
| 2017 July | 6 | 13 | 19 |
| 2017 June | 9 | 12 | 21 |
| 2017 May | 9 | 5 | 14 |
| 2017 April | 5 | 10 | 15 |
| 2017 March | 8 | 30 | 38 |
| 2017 February | 4 | 12 | 16 |
| 2017 January | 1 | 7 | 8 |
| 2016 December | 16 | 11 | 27 |
| 2016 November | 24 | 21 | 45 |
| 2016 October | 18 | 16 | 34 |
| 2016 September | 25 | 20 | 45 |
| 2016 August | 15 | 6 | 21 |
| 2016 July | 22 | 6 | 28 |
| 2016 June | 22 | 9 | 31 |
| 2016 May | 16 | 10 | 26 |
| 2016 April | 8 | 1 | 9 |
| 2016 March | 6 | 0 | 6 |
| 2016 February | 9 | 0 | 9 |
| 2016 January | 20 | 6 | 26 |
| 2015 December | 19 | 8 | 27 |
| 2015 November | 29 | 5 | 34 |
| 2015 October | 10 | 1 | 11 |
| 2015 September | 1 | 0 | 1 |
| 2015 August | 1 | 0 | 1 |
| 2015 June | 1 | 0 | 1 |
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