S L Cohen1,2,3,4, J Wang5,6,7, M Mankerian5, C Feizullayeva5,8,6,7, J A McCandlish9, D Barnaby5,7,10, P Sanelli5,8,6,7, T McGinn5,7,11. 1. Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA. slcohen@northwell.edu. 2. Northwell Health Imaging, 600 Community Drive, Manhasset, NY, 11030, USA. slcohen@northwell.edu. 3. Imaging Clinical Effectiveness & Outcomes Research Program at Northwell Health, 600 Community Drive, Manhasset, NY, 11030, USA. slcohen@northwell.edu. 4. Feinstein Institute for Medical Research at Northwell Health, 600 Community Drive, Manhasset, NY, 11030, USA. slcohen@northwell.edu. 5. Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA. 6. Imaging Clinical Effectiveness & Outcomes Research Program at Northwell Health, 600 Community Drive, Manhasset, NY, 11030, USA. 7. Feinstein Institute for Medical Research at Northwell Health, 600 Community Drive, Manhasset, NY, 11030, USA. 8. Northwell Health Imaging, 600 Community Drive, Manhasset, NY, 11030, USA. 9. Georgia Institute of Technology, Atlanta, GA, USA. 10. Northwell Health Emergency Medicine, Manhasset, NY, USA. 11. Northwell Health Internal Medicine, Manhasset, NY, USA.
Abstract
PURPOSE: The purpose of this study is to determine the rates of CT pulmonary angiography (CTPA) interpreted as limited and severely limited in pregnant patients suspected for pulmonary embolism (PE), and to evaluate factors that influence these rates. METHODS: This is a retrospective study with CTPA for evaluation of PE in pregnancy across a large health system from 2006 to 2017. CTPA was classified as limited from the radiology report with a subset of those studies classified as severely limited. Bivariate and multivariate analysis was performed for limited and severely limited rates with maternal age and patient size as a continuous variable and race, trimester, patient location study priority status, and result of chest radiograph before CTPA as categorical variables. RESULTS: 874 patients with 33% of studies limited and 4% of studies severely limited. Multivariate logistic regression of CTPA studies revealed decreasing patient age (OR 0.967, p = 0.0129) and increasing patient size (OR 1.013, p < 0.0001). Studies performed in the second trimester (OR 1.869, p = 0.0242) and third trimester (OR 2.314, p = 0.0021) were more likely to be reported as limited (each p < 0.05). Increasing patient size (OR 1.017, p = 0.0046) was the only significant predictor of severely limited versus non-severely limited studies. CONCLUSION: CTPA interpreted as limited in pregnancy are common and may be associated with younger age, larger patient size, and second and third trimesters. However, severely limited interpretations are much less common, with patient size the only significant predictor.
PURPOSE: The purpose of this study is to determine the rates of CT pulmonary angiography (CTPA) interpreted as limited and severely limited in pregnant patients suspected for pulmonary embolism (PE), and to evaluate factors that influence these rates. METHODS: This is a retrospective study with CTPA for evaluation of PE in pregnancy across a large health system from 2006 to 2017. CTPA was classified as limited from the radiology report with a subset of those studies classified as severely limited. Bivariate and multivariate analysis was performed for limited and severely limited rates with maternal age and patient size as a continuous variable and race, trimester, patient location study priority status, and result of chest radiograph before CTPA as categorical variables. RESULTS: 874 patients with 33% of studies limited and 4% of studies severely limited. Multivariate logistic regression of CTPA studies revealed decreasing patient age (OR 0.967, p = 0.0129) and increasing patient size (OR 1.013, p < 0.0001). Studies performed in the second trimester (OR 1.869, p = 0.0242) and third trimester (OR 2.314, p = 0.0021) were more likely to be reported as limited (each p < 0.05). Increasing patient size (OR 1.017, p = 0.0046) was the only significant predictor of severely limited versus non-severely limited studies. CONCLUSION:CTPA interpreted as limited in pregnancy are common and may be associated with younger age, larger patient size, and second and third trimesters. However, severely limited interpretations are much less common, with patient size the only significant predictor.
Authors: Ann N Leung; Todd M Bull; Roman Jaeschke; Charles J Lockwood; Phillip M Boiselle; Lynne M Hurwitz; Andra H James; Laurence B McCullough; Yusuf Menda; Michael J Paidas; Henry D Royal; Victor F Tapson; Helen T Winer-Muram; Frank A Chervenak; Dianna D Cody; Michael F McNitt-Gray; Christopher D Stave; Brandi D Tuttle Journal: Radiology Date: 2012-02 Impact factor: 11.105
Authors: Paul D Stein; Sarah E Fowler; Lawrence R Goodman; Alexander Gottschalk; Charles A Hales; Russell D Hull; Kenneth V Leeper; John Popovich; Deborah A Quinn; Thomas A Sos; H Dirk Sostman; Victor F Tapson; Thomas W Wakefield; John G Weg; Pamela K Woodard Journal: N Engl J Med Date: 2006-06-01 Impact factor: 91.245
Authors: Sara A Hayes; Gerald A Soff; Emily C Zabor; Chaya S Moskowitz; Corinne C Liu; Michelle S Ginsberg Journal: Clin Imaging Date: 2014-05-06 Impact factor: 1.605
Authors: P S Wells; D R Anderson; M Rodger; I Stiell; J F Dreyer; D Barnes; M Forgie; G Kovacs; J Ward; M J Kovacs Journal: Ann Intern Med Date: 2001-07-17 Impact factor: 25.391