Table of Contents
ISRN Vascular Medicine
Volume 2013 (2013), Article ID 582413, 4 pages
http://dx.doi.org/10.1155/2013/582413
Research Article

The Use of Computed Tomography of Pulmonary Angiogram in a District Hospital

1Department of Medicine, Timaru Hospital, Private Bag 911, Queen Street, Timaru 7910, New Zealand
2Department of Respiratory Medicine, Christchurch Hospital, Riccarton Avenue, P.O. Box 4710, Christchurch 8140, New Zealand

Received 14 August 2013; Accepted 12 September 2013

Academic Editors: P. Schoenhagen and H. Yoshida

Copyright © 2013 Bomi Kim et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Computed tomography of pulmonary angiogram (CTPA) is a widely used investigation in patients with suspected pulmonary embolism (PE). It is not without adverse effects either through contrast injection or radiation exposure. International guidelines suggest that patients with a low/intermediate clinical probability and negative D-dimer do not require CTPA to exclude PE. Method. A retrospective audit of 100 consecutive CTPA scans was performed at a district general hospital from January to May 2012 to assess adherence to the current guidelines for diagnosis of acute PE and utilisation of CTPA. Result. Of the total 88 CTPA scans that were included in the study, 14% were positive for PE. At least 6%, potentially up to 30% of all the scans, could have been avoided by adherence to current guidelines, thereby improving the positive yield to as high as 19%. Clinical probability scores were documented in only 3%. Orthopaedics requested 3% of all scans and the Assessment Treatment and Rehabilitation (ATR) unit had the highest number of CTPA requests per 100 departmental inpatient admissions. Conclusion. Adherence to the current guidelines can reduce the number of CTPA scans required and may reduce cost, contrast exposure, and radiation burden.