Literature DB >> 18520550

Utilization patterns and diagnostic yield of 3421 consecutive multidetector row computed tomography pulmonary angiograms in a busy emergency department.

Jay H Donohoo1, William W Mayo-Smith, John A Pezzullo, Thomas K Egglin.   

Abstract

OBJECTIVE: To compare examination volume and diagnostic yield of computed tomography (CT) pulmonary angiography (CTPA) and ventilation-perfusion (V/Q) scintigraphy for detection of suspected pulmonary embolism (PE) in emergency department patients.
METHODS: Every CTPA and V/Q scan result for emergency department patients between October 2001 and September 2005 were reviewed. Patients with prior PE and follow-up examinations were excluded.
RESULTS: A total of 3421 CTPA examinations and 198 V/Q scans met inclusion criteria. Average CTPA examinations completed per month increased 227%, from 33.4 to 109.2 for the first and last 24-month periods, respectively. Ventilation-perfusion scintigraphy volume decreased 80% (from 6.9 to 1.4 per month). Total diagnoses of PE per month increased 89% from 4.0 to 7.5, whereas the percentage of positive CTPA examinations dropped from 9.8% to 6.8%.
CONCLUSIONS: Availability of CT in the emergency department and lower physician thresholds for test utilization have increased the use of CT pulmonary angiography and increased detection of PE.

Entities:  

Mesh:

Year:  2008        PMID: 18520550     DOI: 10.1097/RCT.0b013e31812e6af3

Source DB:  PubMed          Journal:  J Comput Assist Tomogr        ISSN: 0363-8715            Impact factor:   1.826


  24 in total

1.  U.S. trends in computed tomography use and diagnoses in emergency department visits by patients with symptoms suggestive of pulmonary embolism, 2001-2009.

Authors:  Lisa B Feng; Jesse M Pines; Hussain R Yusuf; Scott D Grosse
Journal:  Acad Emerg Med       Date:  2013-10       Impact factor: 3.451

2.  Improving appropriate use of pulmonary computed tomography angiography by increasing the serum D-dimer threshold and assessing clinical probability.

Authors:  Sydney Char; Hyo-Chun Yoon
Journal:  Perm J       Date:  2014

3.  Impact of iterative reconstruction on the diagnosis of acute pulmonary embolism (PE) on reduced-dose chest CT angiograms.

Authors:  François Pontana; Simon Henry; Alain Duhamel; Jean-Baptiste Faivre; Nunzia Tacelli; Julien Pagniez; Jacques Remy; Martine Remy-Jardin
Journal:  Eur Radiol       Date:  2015-01-31       Impact factor: 5.315

4.  CT pulmonary angiography after total joint arthroplasty: overdiagnosis and iatrogenic harm?

Authors:  Michele R D'Apuzzo; Thomas C Keller; Wendy M Novicoff; James A Browne
Journal:  Clin Orthop Relat Res       Date:  2013-05-10       Impact factor: 4.176

5.  Yield of CT Pulmonary Angiography in the Emergency Department When Providers Override Evidence-based Clinical Decision Support.

Authors:  Zihao Yan; Ivan K Ip; Ali S Raja; Anurag Gupta; Joshua M Kosowsky; Ramin Khorasani
Journal:  Radiology       Date:  2016-09-30       Impact factor: 11.105

6.  The RSNA Pulmonary Embolism CT Dataset.

Authors:  Errol Colak; Felipe C Kitamura; Stephen B Hobbs; Carol C Wu; Matthew P Lungren; Luciano M Prevedello; Jayashree Kalpathy-Cramer; Robyn L Ball; George Shih; Anouk Stein; Safwan S Halabi; Emre Altinmakas; Meng Law; Parveen Kumar; Karam A Manzalawi; Dennis Charles Nelson Rubio; Jacob W Sechrist; Pauline Germaine; Eva Castro Lopez; Tomas Amerio; Pushpender Gupta; Manoj Jain; Fernando U Kay; Cheng Ting Lin; Saugata Sen; Jonathan Wesley Revels; Carola C Brussaard; John Mongan
Journal:  Radiol Artif Intell       Date:  2021-01-20

7.  Serial use of existing clinical decisions aids can reduce computed tomography pulmonary angiography for pulmonary embolism.

Authors:  Robert Russell Ehrman; Adrienne Nicole Malik; Reid Kenneth Smith; Zeid Kalarikkal; Andrew Huang; Ryan Michael King; Rubin David Green; Brian James O'Neil; Robert Leigh Sherwin
Journal:  Intern Emerg Med       Date:  2021-03-20       Impact factor: 3.397

8.  "Pulmonary Vein Sign" for Pulmonary Embolism Diagnosis in Computed Tomography Angiography.

Authors:  Luciana Volpon Soares Souza; Matheus Zanon; Arthur Soares Souza; Klaus Irion; Diana Penha; Giordano Rafael Tronco Alves; Edson Marchiori; Bruno Hochhegger
Journal:  Lung       Date:  2017-10-14       Impact factor: 2.584

9.  Time trends in pulmonary embolism in the United States: evidence of overdiagnosis.

Authors:  Renda Soylemez Wiener; Lisa M Schwartz; Steven Woloshin
Journal:  Arch Intern Med       Date:  2011-05-09

10.  Could the number of CT angiograms be reduced in emergency department patients suspected of pulmonary embolism?

Authors:  Zehtabchi Shahriar; Rinnert Stephan; Malhotra Shweta; Subramanian Arun; Timberger Mathew; Patel Brijal; Toro David; Hassan Khaled; Sinert Richard
Journal:  World J Emerg Med       Date:  2012
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