Literature DB >> 9353458

Treatment of patients with suspected pulmonary embolism and intermediate-probability lung scans: is diagnostic imaging underused?

R Khorasani1, T F Gudas, N Nikpoor, J F Polak.   

Abstract

OBJECTIVE: We compared patient treatment with imaging strategy in patients with clinically suspected pulmonary embolism (PE) and intermediate-probability lung scans (IPLS).
MATERIALS AND METHODS: We retrospectively reviewed the medical records of 214 consecutive patients with clinically suspected PE with IPLS.
RESULTS: Treatment (full anticoagulation, filter placement, or both) was given in 66 (31%) of 214 patients. Only 37% of patients were treated on the basis of definitive diagnostic imaging results. Most patients (134 [63%] of 214) were treated without an imaging diagnosis: 30 (14%) of 214 patients were treated for acute PE on clinical grounds, and the diagnosis of PE was not excluded in 104 (49%) of 214 patients.
CONCLUSION: Most patients with IPLS are treated without a definitive imaging diagnosis. This lack of diagnosis may result in the overtreatment of patients who do not have acute PE or, more importantly, in the undertreatment of patients who do have acute PE. Further studies are necessary to evaluate the impact of the current management strategies on patient outcome.

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Year:  1997        PMID: 9353458     DOI: 10.2214/ajr.169.5.9353458

Source DB:  PubMed          Journal:  AJR Am J Roentgenol        ISSN: 0361-803X            Impact factor:   3.959


  4 in total

1.  Diagnostic approach to patients with suspected pulmonary embolism: a report from the real world.

Authors:  G Saro; J F Campo; M J Hernández; M Anta; J M Olmos; J González-Macías; J A Riancho
Journal:  Postgrad Med J       Date:  1999-05       Impact factor: 2.401

2.  British Thoracic Society guidelines for the management of suspected acute pulmonary embolism.

Authors: 
Journal:  Thorax       Date:  2003-06       Impact factor: 9.139

3.  Pulmonary embolism: is multislice CT the method of choice? For.

Authors:  Ieneke J C Hartmann; Mathias Prokop
Journal:  Eur J Nucl Med Mol Imaging       Date:  2005-01       Impact factor: 9.236

Review 4.  Is the lung scan alive and well? Facts and controversies in defining the role of lung scintigraphy for the diagnosis of pulmonary embolism in the era of MDCT.

Authors:  John H Reid; Emmanuel E Coche; Tomio Inoue; Edmund E Kim; Maurizio Dondi; Naoyuki Watanabe; Giuliano Mariani
Journal:  Eur J Nucl Med Mol Imaging       Date:  2009-01-27       Impact factor: 9.236

  4 in total

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