Ogawa et al reported a score for the diagnosis of pulomonary veno-occlusive disease/pulmonary capillary hemangiomatosis (PVOD/PCH). The authors are from National Hospital Organization Okayama Medical Center in Japan.
Patient selection: pulmonary hypertensions
Parameters:
(1) sex
(2) smoking history
(3) six minute walking distance (6MWD) in meters
(4) minimum oxygen saturation by pulse oximeter in percent during 6MWD
(5) diffusion capacity of carbon monoxide as percent of predicted
(6) ground glass opacity seen on high-resolution CT
(7) thickening of interlobular septa on high-resolution CT
(8) defect in perfusion lung scan
(9) pulmonary edema due to vasodilators
|
Parameter
|
Finding
|
Points
|
|
sex
|
female
|
0
|
|
|
male
|
1
|
|
smoking history
|
no
|
0
|
|
|
yes
|
1
|
|
6MWD
|
< 285 meters
|
1
|
|
|
>= 285 meters
|
0
|
|
minimum oxygen saturation
|
< 92%
|
1
|
|
|
>= 92%
|
0
|
|
DLco as percent of predicted
|
< 34%
|
1
|
|
|
>= 34%
|
0
|
|
ground glass opacities
|
no
|
0
|
|
|
yes
|
1
|
|
thickened interlobular septae
|
no
|
0
|
|
|
yes
|
1
|
|
defect in perfusion lung scan
|
no
|
0
|
|
|
yes
|
1
|
|
pulmonary edema due to vasodilators
|
no
|
0
|
|
|
yes
|
2
|
total score =
= SUM(points for all 9 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• A score >= 5 is associated with high risk for PVOD/PCH.
Performance:
• The area under the ROC curve was 0.99.
• The sensitivity was 95% and specificity 98%.
