CT pulmonary angiography appropriateness in a single emergency department: does the use of revised Geneva score matter?
Age-adjusted D-dimer cut-offs
Computed tomography pulmonary angiography
Pulmonary embolism
Revised Geneva score
Journal
La Radiologia medica
ISSN: 1826-6983
Titre abrégé: Radiol Med
Pays: Italy
ID NLM: 0177625
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
18
04
2021
accepted:
30
08
2021
pubmed:
15
9
2021
medline:
11
1
2022
entrez:
14
9
2021
Statut:
ppublish
Résumé
To assess the percentage of computed tomography pulmonary angiography (CTPA) procedures that could have been avoided by methodical application of the Revised Geneva Score (RGS) coupled with age-adjusted D-dimer cut-offs rather than only clinical judgment in Emergency Department patients with suspected pulmonary embolism (PE). Between November 2019 and May 2020, 437 patients with suspected PE based on symptoms and D-dimer test were included in this study. All patients underwent to CTPA. For each patient, we retrospectively calculated the age-adjusted D-dimer cut-offs and the RGS in the original version. Finally, CT images were retrospectively reviewed, and the presence of PE was recorded. In total, 43 (9.84%) CTPA could have been avoided by use of RGS coupled with age-adjusted D-dimer cut-offs. Prevalence of PE was 14.87%. From the analysis of 43 inappropriate CTPA, 24 (55.81%) of patients did not show any thoracic signs, two (4.65%) of patients had PE, and the remaining patients had alternative thoracic findings. The study showed good prevalence of PE diagnoses in our department using only physician assessment, although 9.84% CTPA could have been avoided by methodical application of RGS coupled with age-adjusted D-dimer cut-offs.
Identifiants
pubmed: 34518985
doi: 10.1007/s11547-021-01416-x
pii: 10.1007/s11547-021-01416-x
pmc: PMC8702417
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1544-1552Informations de copyright
© 2021. The Author(s).
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