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CT pulmonary angiography appropriateness in a single emergency department: does the use of revised Geneva score matter?
- Source :
-
La Radiologia medica [Radiol Med] 2021 Dec; Vol. 126 (12), pp. 1544-1552. Date of Electronic Publication: 2021 Sep 13. - Publication Year :
- 2021
-
Abstract
- Purpose: 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).<br />Material and Methods: 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.<br />Results: 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.<br />Conclusion: 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.<br /> (© 2021. The Author(s).)
Details
- Language :
- English
- ISSN :
- 1826-6983
- Volume :
- 126
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- La Radiologia medica
- Publication Type :
- Academic Journal
- Accession number :
- 34518985
- Full Text :
- https://doi.org/10.1007/s11547-021-01416-x