Analysis of CTPA guideline compliance in suspected patients of pulmonary embolism
Chen Yujiao
Li Shu
Zhang Hua
Ma Qingbian
Ge Hongxia
Abstract：Objective To analyze the guideline compliance of computed tomographic pulmonaric angiography(CTPA)in the suspected patients of pulmonary embolism(PE)in emergency department.Methods This was a single-center retrospective study.Clinical data of patients who underwent CTPA in the emergency department of Peking University Third Hospital from January 1,2018 to December 31,2021 were collected.According to CTPA results,the patients were divided into PE group and non-PE group.Simplified Wells score(mWS),revised Geneva score(rGS)and YEARs score were calculated for the clinical possibility of PE for each patient according to European Society of Cardiology(ESC)guideline recommendations.The guidelines compliance was analyzed.Results A total of 1 062 suspected PE patients were included,and were divided into PE group(341 cases)and non-PE group(721 cases)according to CTPA results.CTPA positive rate was 32.1%.CTPA compliance rates were 75.8%,79.8%and 65.6%according to the recommendation processes of three scores,respectively.CTPA positive rate was increased to 39.0%(P =0.002),37.3%(P =0.018)and 40.2%(P<0.001),respectively.There were 68 patients with a positive CTPA result despite a low or unlikely clinical likelihood of PE.Conclusions The CTPA examination procedure recommended by the guidelines can significantly improve the positive rate of PE diagnosis.Further attention should be paid to PE patients with negative scores to improve the accuracy of diagnosis.
Keywords：Pulmonary embolismComputed tomographic pulmonary angiography(CTPA)Guideline complianceD-dimerSimplified Wells scoreRevised Geneva scoreYEARs score
Publication Date：2024-03-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 220-225 )