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Examination of hospital referral practices for CT pulmonary angiography
Author(s) -
Kiley Cristin A.,
Lowry Kristie J.,
Mysliwiec Vincent
Publication year - 2007
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.189
Subject(s) - medicine , hospital medicine , retrospective cohort study , referral , pulmonary angiography , pulmonary embolism , radiology , emergency medicine , venous thromboembolism , emergency department , physical examination , angiography , surgery , thrombosis , family medicine , psychiatry
Guidelines for the evaluation of venous thromboembolism (VTE) include a history and physical examination in conjunction with computed tomographic pulmonary angiography (CTPA), Doppler ultrasonography, and D ‐dimer measurements. We performed a retrospective analysis to evaluate the diagnostic yield of CTPA at our facility. Patients between the ages of 18 and100 with a CTPA completed through the emergency department and/or any inpatient service over a 6‐month period were reviewed and a retrospective Simplified Wells Score was calculated. Three hundred and three patients underwent CTPA for acute VTE. A Simplified Wells Score was calculated for 279 subjects, with a mean score of 1.6 ± 1.6. Twenty CTPA procedures demonstrated VTE, a positive rate of 7.2%, which was lower than expected. This result likely reflects lack of adherence to a clinical algorithm for assessment of VTE and an overly cautious approach to symptom evaluation. Journal of Hospital Medicine 2007;2:253–257. © 2007 Society of Hospital Medicine.