Study on the Diagnostic Value of Clinical Decision Rules for Malignant Tumors Complicated with Pulmonary Thromboembolism: A Retrospective Analysis.

BackgroundRecently released clinical decision rules (CDR) have demonstrated strong performance in diagnosing pulmonary thromboembolism (PTE) within the general population; however, there is a notable lack of comparative analysis regarding the diagnosis of PTE in patients with malignant tumor.ObjectiveTo evaluate the diagnostic efficacy of CDR for PTE in patients with malignant and non-malignant tumors.MethodsA retrospective analysis was conducted on 537 patients who underwent CT pulmonary arteriography (CTPA) for suspected PTE at Yantaishan Hospital from October 2014 to March 2024. Clinical characteristics of the patients were collected, clinical decision rule scores were calculated, and their diagnostic value was assessed.ResultsIn the malignant tumor group, the area under the curve (AUC) for the Wells score, revised Geneva score, age-adjusted d-dimer score (AADD), Years score, pulmonary embolism graduated d-dimer score (PEGeD), and the 4-level clinical pretest probability score (4PEPS) were 0.644, 0.584, 0.662, 0.663, 0.671, and 0.665, respectively, all below 0.7. The diagnostic performance of the Wells, AADD, Years, PEGeD, and 4PEPS score was superior to that of the revised Geneva score. In the non-malignant tumor group, the AUC values for the Wells score, revised Geneva score, AADD, YEARS score, PEGeD score, and 4PEPS score were 0.711, 0.699, 0.748, 0.756, 0.762, and 0.750, respectively. All AUC values exceeded 0.7 except for the revised Geneva score.ConclusionCDR was less effective in diagnosing PTE in patients with malignant tumors and was more suitable for those with non-malignant tumors.