Table of Contents Author Guidelines Submit a Manuscript
Pulmonary Medicine
Volume 2013, Article ID 915213, 6 pages
http://dx.doi.org/10.1155/2013/915213
Clinical Study

Utilization of CT Pulmonary Angiography in Suspected Pulmonary Embolism in a Major Urban Emergency Department

1Division of Pulmonary and Critical Care Medicine, College of Medicine at Jacksonville, University of Florida, Jacksonville, FL, USA
2University of Florida, Shands Clinical Center, 655 West 8th Street, Suite 7-088, Jacksonville, FL 32209, USA
3Division of Pulmonary and Critical Care Medicine, St. Luke’s and Roosevelt Hospitals of Columbia University, New York, NY, USA

Received 7 March 2013; Accepted 28 July 2013

Academic Editor: Nicole S. L. Goh

Copyright © 2013 Adil Shujaat 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.

Linked References

  1. P. S. Wells, D. R. Anderson, M. Rodger et al., “Excluding pulmonary embolism at the bedside without diagnostic imaging: management of patients with suspected pulmonary embolism presenting to the emergency department by using a simple clinical model and D-dimer,” Annals of Internal Medicine, vol. 135, no. 2, pp. 98–107, 2001. View at Google Scholar · View at Scopus
  2. M. J. H. A. Kruip, M. J. Slob, J. H. E. M. Schijen, C. van der Heul, and H. R. Büller, “Use of a clinical decision rule in combination with D-dimer concentration in diagnostic workup of patients with suspected pulmonary embolism: a prospective management study,” Archives of Internal Medicine, vol. 162, no. 14, pp. 1631–1635, 2002. View at Publisher · View at Google Scholar · View at Scopus
  3. I. Chagnon, H. Bounameaux, D. Aujesky et al., “Comparison of two clinical prediction rules and implicit assessment among patients with suspected pulmonary embolism,” The American Journal of Medicine, vol. 113, no. 4, pp. 269–275, 2002. View at Publisher · View at Google Scholar · View at Scopus
  4. S. J. Wolf, T. R. McCubbin, K. M. Feldhaus, J. P. Faragher, and D. M. Adcock, “Prospective validation of wells criteria in the evaluation of patients with suspected pulmonary embolism,” Annals of Emergency Medicine, vol. 44, no. 5, pp. 503–510, 2004. View at Publisher · View at Google Scholar · View at Scopus
  5. A. van Belle, H. R. Büller, M. V. Huisman, P. M. Huisman et al., “Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography,” Journal of the American Medical Association, vol. 295, no. 2, pp. 172–179, 2006. View at Publisher · View at Google Scholar · View at Scopus
  6. J. E. Dalen, “Pulmonary embolism: what have we learned since Virchow? Natural history, pathophysiology, and diagnosis,” Chest, vol. 122, no. 4, pp. 1440–1456, 2002. View at Publisher · View at Google Scholar · View at Scopus
  7. S. Iles, L. Beckert, M. Than, and G. I. Town, “Making a diagnosis of pulmonary embolism: new methods and clinical issues,” New Zealand Medical Journal, vol. 116, no. 1177, 2003. View at Google Scholar · View at Scopus
  8. H. C. Sox, M. A. Blatt, M. C. Higgins et al., Medical Decision Making, Butterworth-Heineman, Woburn, Mass, USA, 1988.
  9. L. K. Moores, W. L. Jackson Jr., A. F. Shorr, and J. L. Jackson, “Meta-analysis: outcomes in patients with suspected pulmonary embolism managed with computed tomographic pulmonary angiography,” Annals of Internal Medicine, vol. 141, no. 11, pp. 866–874, 2004. View at Google Scholar · View at Scopus
  10. R. Quiroz, N. Kucher, K. H. Zou et al., “Clinical validity of a negative computed tomography scan in patients with suspected pulmonary embolism: a systematic review,” Journal of the American Medical Association, vol. 293, no. 16, pp. 2012–2017, 2005. View at Publisher · View at Google Scholar · View at Scopus
  11. M. J. L. van Strijen, J. L. Bloem, W. de Monye et al., “Helical computed tomography and alternative diagnosis in patients with excluded pulmonary embolism,” Journal of Thrombosis and Haemostasis, vol. 3, no. 11, pp. 2449–2456, 2005. View at Publisher · View at Google Scholar · View at Scopus
  12. K.-L. Tsai, E. Gupta, and L. B. Haramati, “Pulmonary atelectasis: a frequent alternative diagnosis in patients undergoing CT-PA for suspected pulmonary embolism,” Emergency Radiology, vol. 10, no. 5, pp. 282–286, 2004. View at Publisher · View at Google Scholar · View at Scopus
  13. P. S. Wells, D. R. Anderson, M. Rodger et al., “Derivation of a simple clinical model to categorize patients probability of pulmonary embolism: increasing the models utility with the SimpliRED D-dimer,” Thrombosis and Haemostasis, vol. 83, no. 3, pp. 416–420, 2000. View at Google Scholar · View at Scopus
  14. K.-E. Lim, C.-Y. Chan, P.-H. Chu, Y.-Y. Hsu, and W.-C. Hsu, “Right ventricular dysfunction secondary to acute massive pulmonary embolism detected by helical computed tomography pulmonary angiography,” Clinical Imaging, vol. 29, no. 1, pp. 16–21, 2005. View at Publisher · View at Google Scholar · View at Scopus
  15. M. A. Rodger, E. Maser, I. Stiell, H. E. A. Howley, and P. S. Wells, “The interobserver reliability of pretest probability assessment in patients with suspected pulmonary embolism,” Thrombosis Research, vol. 116, no. 2, pp. 101–107, 2005. View at Publisher · View at Google Scholar · View at Scopus
  16. S. Iles, A. M. Hodges, J. R. Darley et al., “Clinical experience and pre-test probability scores in the diagnosis of pulmonary embolism,” Monthly Journal of the Association of Physicians, vol. 96, no. 3, pp. 211–215, 2003. View at Publisher · View at Google Scholar · View at Scopus
  17. J. Wicki, T. V. Perneger, A. F. Junod, H. Bounameaux, and A. Perrier, “Assessing clinical probability of pulmonary embolism in the emergency ward: a simple score,” Archives of Internal Medicine, vol. 161, no. 1, pp. 92–97, 2001. View at Google Scholar · View at Scopus
  18. G. Waser, S. Kathriner, and W. A. Wuillemin, “Performance of the automated and rapid STA Liatest D-dimer on the STA-R analyzer,” Thrombosis Research, vol. 116, no. 2, pp. 165–170, 2005. View at Publisher · View at Google Scholar · View at Scopus
  19. R. E. G. Schutgens, F. J. L. M. Haas, W. B. M. Gerritsen, F. van der Horst, H. K. Nieuwenhuis, and D. H. Biesma, “The usefulness of five D-dimer assays in the exclusion of deep venous thrombosis,” Journal of Thrombosis and Haemostasis, vol. 1, no. 5, pp. 976–981, 2003. View at Publisher · View at Google Scholar · View at Scopus
  20. S. Namasivayam, M. K. Kalra, W. E. Torres, and W. C. Small, “Adverse reactions to intravenous iodinated contrast media: a primer for radiologists,” Emergency Radiology, vol. 12, no. 5, pp. 210–215, 2006. View at Publisher · View at Google Scholar · View at Scopus
  21. M. S. Parker, F. K. Hui, M. A. Camacho, J. K. Chung, D. W. Broga, and N. N. Sethi, “Female breast radiation exposure during CT pulmonary angiography,” The American Journal of Roentgenology, vol. 185, no. 5, pp. 1228–1233, 2005. View at Publisher · View at Google Scholar · View at Scopus
  22. L. M. Hurwitz, T. Yoshizumi, R. E. Reiman et al., “Radiation dose to the fetus from body MDCT during early gestation,” The American Journal of Roentgenology, vol. 186, no. 3, pp. 871–876, 2006. View at Publisher · View at Google Scholar · View at Scopus
  23. A. Berrington de González, M. Mahesh, K.-P. Kim et al., “Projected cancer risks from computed tomographic scans performed in the United States in 2007,” Archives of Internal Medicine, vol. 169, no. 22, pp. 2071–2077, 2009. View at Publisher · View at Google Scholar · View at Scopus
  24. D. J. Brenner and E. J. Hall, “Computed tomography: an increasing source of radiation exposure,” The New England Journal of Medicine, vol. 357, no. 22, pp. 2277–2284, 2007. View at Google Scholar
  25. A. Sodickson, P. F. Baeyens, K. P. Andriole et al., “Recurrent CT, cumulative radiation exposure, and associated radiation-induced cancer risks from CT of adults,” Radiology, vol. 251, no. 1, pp. 175–184, 2009. View at Publisher · View at Google Scholar · View at Scopus
  26. H. T. Winer-Muram, J. M. Boone, H. L. Brown, S. G. Jennings, W. C. Mabie, and G. T. Lombardo, “Pulmonary embolism in pregnant patients: fetal radiation dose with helical CT,” Radiology, vol. 224, no. 2, pp. 487–492, 2002. View at Google Scholar · View at Scopus
  27. J.-A. Lee, B. K. Zierler, C.-F. Liu, and M. K. Chapko, “Cost-effective diagnostic strategies in patients with a high, intermediate, or low clinical probability of pulmonary embolism,” Vascular and Endovascular Surgery, vol. 45, no. 2, pp. 113–121, 2011. View at Publisher · View at Google Scholar · View at Scopus
  28. S. Grifoni, I. Olivotto, P. Cecchini et al., “Short-term clinical outcome of patients with acute pulmonary embolism, normal blood pressure, and echocardiographic right ventricular dysfunction,” Circulation, vol. 101, no. 24, pp. 2817–2822, 2000. View at Google Scholar · View at Scopus
  29. N. Mansencal, T. Joseph, A. Vieillard-Baron et al., “Diagnosis of right ventricular dysfunction in acute pulmonary embolism using helical computed tomography,” The American Journal of Cardiology, vol. 95, no. 10, pp. 1260–1263, 2005. View at Publisher · View at Google Scholar · View at Scopus
  30. A. Ghuysen, B. Ghaye, V. Willems et al., “Computed tomographic pulmonary angiography and prognostic significance in patients with acute pulmonary embolism,” Thorax, vol. 60, no. 11, pp. 956–961, 2005. View at Publisher · View at Google Scholar · View at Scopus
  31. W. Kasper, S. Konstantinides, A. Geibel, N. Tiede, T. Krause, and H. Just, “Prognostic significance of right ventricular afterload stress detected by echocardiography in patients with clinically suspected pulmonary embolism,” Heart, vol. 77, no. 4, pp. 346–349, 1997. View at Google Scholar · View at Scopus
  32. S. Z. Goldhaber, W. D. Haire, M. L. Feldstein et al., “Alteplase versus heparin in acute pulmonary embolism: randomised trial assessing right-ventricular function and pulmonary perfusion,” The Lancet, vol. 341, no. 8844, pp. 507–511, 1993. View at Publisher · View at Google Scholar · View at Scopus
  33. A. Ribeiro, P. Lindmarker, A. Juhlin-Dannfelt, H. Johnsson, and L. Jorfeldt, “Echocardiography Doppler in pulmonary embolism: right ventricular dysfunction as a predictor of mortality rate,” The American Heart Journal, vol. 134, no. 3, pp. 479–487, 1997. View at Publisher · View at Google Scholar · View at Scopus
  34. O. Sanchez, L. Trinquart, I. Colombet et al., “Prognostic value of right ventricular dysfunction in patients with haemodynamically stable pulmonary embolism: a systematic review,” European Heart Journal, vol. 29, no. 12, pp. 1569–1577, 2008. View at Publisher · View at Google Scholar · View at Scopus
  35. G. Coutance, E. Cauderlier, J. Ehtisham, M. Hamon, and M. Hamon, “The prognostic value of markers of right ventricular dysfunction in pulmonary embolism: a meta-analysis,” Critical Care, vol. 15, no. 2, article R103, 2011. View at Publisher · View at Google Scholar · View at Scopus