The positive rate of pulmonary embolism by CT pulmonary angiography is high in an emergency department —even in low-risk or young patients

Objective: The clinical presentation of pulmonary embolism (PE) can be various and misleading. We analysed patients with suspicion of PE and subsequently performed computed tomography pulmonary angiography (CTPA) in an emergency department of Internal Medicine, focusing on patient groups in which PE might be underestimated in the emergency setting, such as young patients and patients with low clinical probability. Material and Methods: In 2016 and 2017, all patients receiving a CTPA for the question of PE were retrospectively evaluated for clinical (age, symptoms, vital parameters) and D-Dimers. The Wells score was calculated. Results: In 323 patients (158 female, 165 male, mean age 62 years) a CTPA was performed. The leading symptoms for admission were dyspnea or chest pain. 62% showed intermediate or high risk for PE, calculated by applying the Wells score. In 123 (38%) of all patients a PE was proved and pathologic age-adjusted D-Dimers were found in 97.6%. 30/121 (25%) of all patients with low risk according to Wells score had a PE. A deep vein thrombosis was currently verified in 67/123 (55%). 43% (15/35) of all suspicions for PE in patients
Source: Medical Principles and Practice - Category: Internal Medicine Source Type: research