Abstract:Objective To explore the predictive value of 4-level pulmonary embolism clinical probability score（4PEPS） in the diagnosis of pulmonary embolism（PE）. Methods A retrospective analysis was performed on 540 inpatients who underwent CT pulmonary arteriography（CTPA） for suspected PE at the Second Affiliated Hospital of Zhengzhou University from January 2019 to March 2022. With CTPA as the gold standard, 4PEPS score, YEARS score （algorithm for diagnosis of suspected PE） and simplified Wells score and age-adjusted D-dimer scheme（sWells-Age scheme） were collected to compare the predictive values of them in the diagnosis of PE. Results Of 540 inpatients, 171 cases of PE were confirmed by CTPA. The sensitivities of 4PEPS score, sWells-Age scheme and YEARS score were 84.21%, 83.04% and 75.44%, respectively,with the specificities of 55.28%, 36.59% and 47.97%, respectively and the negative predictive values of 88.31%, 83.32% and 80.82%,respectively. The area under the ROC curve of 4PEPS score（0.697） was largest, followed by YEARS score（0.617） and sWells-Age scheme（0.598） in diagnosing PE. Meanwhile, the 4PEPS score avoided 37.78% of CTPA examinations, with a decrease of 12.78% compared to the sWells-Age protocol (25.00%) and a decrease of 5.00% compared to the YEARS score (32.78%). Conclusion 4PEPS score has better application value in predicting PE. It will reduce the number of CTPA examinations by 37.78%, which is better than YEARS score and sWells-Age scheme, and is worthy of further verification in clinical practice.