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Investigation of Suspected Pulmonary Embolism at Hutt Valley Hospital with CT Pulmonary Angiography: Current Practice and Opportunities for Improvement.

Kennedy N, Jayathissa S, Healy P - Adv Med (2015)

Bottom Line: Conclusion.Risk stratification of suspected PE using Wells score and D Dimer was underutilised.A number of scans could have been safely avoided by using accepted guidelines reducing resources use and improving patient safety.

View Article: PubMed Central - PubMed

Affiliation: Hutt Valley District Health Board, Lower Hutt, Wellington 5040, New Zealand.

ABSTRACT
Aims. To study the use of CT pulmonary angiography (CTPA) at Hutt Hospital and investigate the use of pretest probability scoring in the assessment of patients with suspected pulmonary embolism (PE). Methods. We studied patients with suspected PE that underwent CTPA between January and May 2012 and collected data on demographics, use of pretest probability scoring, and use of D Dimer and compared our practice with the British Thoracic Society (BTS) guideline. Results. 105 patients underwent CTPA and 15% of patients had PE. 13% of patients had a Wells score prior to their scan. Wells score calculated by researchers revealed 54%, 36%, and 8% patients had low, medium, and high risk pretest probabilities and 8%, 20%, and 50% of these patients had positive scans. D Dimer was performed in 58% of patients and no patients with a negative D Dimer had a PE. Conclusion. The CTPA positive rate was similar to other contemporary studies but lower than previous New Zealand studies and some international guidelines. Risk stratification of suspected PE using Wells score and D Dimer was underutilised. A number of scans could have been safely avoided by using accepted guidelines reducing resources use and improving patient safety.

No MeSH data available.


Related in: MedlinePlus

Results of scans by department.
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fig3: Results of scans by department.

Mentions: The mean age of patients scanned was 63.7 years (range 20–98). 60% of patients were female. 18% had a history of previous thromboembolism, 11% had a history of active or recently treated cancer, and 22% had had a recent operation or significant immobility. Four of the patients were either pregnant or postpartum. 15% of scans were positive for pulmonary embolism. There was no marked variation in rate of positive scans by department (Figure 3).


Investigation of Suspected Pulmonary Embolism at Hutt Valley Hospital with CT Pulmonary Angiography: Current Practice and Opportunities for Improvement.

Kennedy N, Jayathissa S, Healy P - Adv Med (2015)

Results of scans by department.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4590957&req=5

fig3: Results of scans by department.
Mentions: The mean age of patients scanned was 63.7 years (range 20–98). 60% of patients were female. 18% had a history of previous thromboembolism, 11% had a history of active or recently treated cancer, and 22% had had a recent operation or significant immobility. Four of the patients were either pregnant or postpartum. 15% of scans were positive for pulmonary embolism. There was no marked variation in rate of positive scans by department (Figure 3).

Bottom Line: Conclusion.Risk stratification of suspected PE using Wells score and D Dimer was underutilised.A number of scans could have been safely avoided by using accepted guidelines reducing resources use and improving patient safety.

View Article: PubMed Central - PubMed

Affiliation: Hutt Valley District Health Board, Lower Hutt, Wellington 5040, New Zealand.

ABSTRACT
Aims. To study the use of CT pulmonary angiography (CTPA) at Hutt Hospital and investigate the use of pretest probability scoring in the assessment of patients with suspected pulmonary embolism (PE). Methods. We studied patients with suspected PE that underwent CTPA between January and May 2012 and collected data on demographics, use of pretest probability scoring, and use of D Dimer and compared our practice with the British Thoracic Society (BTS) guideline. Results. 105 patients underwent CTPA and 15% of patients had PE. 13% of patients had a Wells score prior to their scan. Wells score calculated by researchers revealed 54%, 36%, and 8% patients had low, medium, and high risk pretest probabilities and 8%, 20%, and 50% of these patients had positive scans. D Dimer was performed in 58% of patients and no patients with a negative D Dimer had a PE. Conclusion. The CTPA positive rate was similar to other contemporary studies but lower than previous New Zealand studies and some international guidelines. Risk stratification of suspected PE using Wells score and D Dimer was underutilised. A number of scans could have been safely avoided by using accepted guidelines reducing resources use and improving patient safety.

No MeSH data available.


Related in: MedlinePlus