Research Article

Evaluation of the Years Algorithm for the Diagnosis of Pulmonary Embolism at the University Hospital Centre in Lome (Togo)

Authors: Pessinaba S, Kpelafia MI, Afassinou M, Donmani D, Yayehd K, Togbossi E, Pio M, Baragou S, Damorou F.

DOI: 10.33425/2639-8486.1218

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Abstract

Introduction: Pulmonary embolism (PE) is a medical emergency whose diagnosis relies on costly and invasive paraclinical tools, particularly chest CT angiography. The YEARS algorithm combines simple clinical criteria and D-dimer testing to limit unnecessary examinations.

Objective: To evaluate the performance of the YEARS algorithm at the Lomé University Hospital Campus and determine its ability to reduce requests for CT angiography.

Methods: Retrospective cross-sectional study (2015-2021) including patients hospitalised for suspected PE with D-dimers and CT angiography available. Diagnostic performance indices (sensitivity, specificity, PPV, NPV) calculated according to standard formulas.

Results: 238 patients included (mean age 56.5 ±16.2 years; male-to-female ratio =0.31). PE confirmed in 126 patients (52.9%). The YEARS algorithm would have ruled out PE in 26 patients (23.2%) with low clinical probability and D-dimers <1000 ng/mL. Sensitivity: 90.9%, NPV: 76.4%. With local prevalence (3.1%), adjusted NPV: 99%. Eight patients (3.4%) would have been false negatives.

Conclusion: The YEARS algorithm is a reliable and effective tool for limiting unnecessary CT angiograms in suspected PE cases at the Lomé University Hospital Campus.

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