CT pulmonary angiography: increasingly diagnosing less severe pulmonary emboli.
It is unknown whether the observed increase in computed tomography pulmonary angiography (CTPA) utilization has resulted in increased detection of pulmonary emboli (PEs) with a less severe disease spectrum.Trends in utilization, diagnostic yield, and disease severity were evaluated for 4,048 consecu...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2013-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3680477?pdf=render |
| _version_ | 1818506003181731840 |
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| author | Andrew J Schissler Anna Rozenshtein Michal E Kulon Gregory D N Pearson Robert A Green Peter D Stetson David J Brenner Belinda D'Souza Wei-Yann Tsai Neil W Schluger Andrew J Einstein |
| author_facet | Andrew J Schissler Anna Rozenshtein Michal E Kulon Gregory D N Pearson Robert A Green Peter D Stetson David J Brenner Belinda D'Souza Wei-Yann Tsai Neil W Schluger Andrew J Einstein |
| author_sort | Andrew J Schissler |
| collection | DOAJ |
| description | It is unknown whether the observed increase in computed tomography pulmonary angiography (CTPA) utilization has resulted in increased detection of pulmonary emboli (PEs) with a less severe disease spectrum.Trends in utilization, diagnostic yield, and disease severity were evaluated for 4,048 consecutive initial CTPAs performed in adult patients in the emergency department of a large urban academic medical center between 1/1/2004 and 10/31/2009. Transthoracic echocardiography (TTE) findings and peak serum troponin levels were evaluated to assess for the presence of PE-associated right ventricular (RV) abnormalities (dysfunction or dilatation) and myocardial injury, respectively. Statistical analyses were performed using multivariate logistic regression.268 CTPAs (6.6%) were positive for acute PE, and 3,780 (93.4%) demonstrated either no PE or chronic PE. There was a significant increase in the likelihood of undergoing CTPA per year during the study period (odds ratio [OR] 1.05, 95% confidence interval [CI] 1.04-1.07, P<0.01). There was no significant change in the likelihood of having a CTPA diagnostic of an acute PE per year (OR 1.03, 95% CI 0.95-1.11, P = 0.49). The likelihood of diagnosing a less severe PE on CTPA with no associated RV abnormalities or myocardial injury increased per year during the study period (OR 1.39, 95% CI 1.10-1.75, P = 0.01).CTPA utilization has risen with no corresponding change in diagnostic yield, resulting in an increase in PE detection. There is a concurrent rise in the likelihood of diagnosing a less clinically severe spectrum of PEs. |
| first_indexed | 2024-12-10T21:58:32Z |
| format | Article |
| id | doaj.art-8b03b532e2ea4d12be52e909429a9059 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-10T21:58:32Z |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-8b03b532e2ea4d12be52e909429a90592022-12-22T01:31:58ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0186e6566910.1371/journal.pone.0065669CT pulmonary angiography: increasingly diagnosing less severe pulmonary emboli.Andrew J SchisslerAnna RozenshteinMichal E KulonGregory D N PearsonRobert A GreenPeter D StetsonDavid J BrennerBelinda D'SouzaWei-Yann TsaiNeil W SchlugerAndrew J EinsteinIt is unknown whether the observed increase in computed tomography pulmonary angiography (CTPA) utilization has resulted in increased detection of pulmonary emboli (PEs) with a less severe disease spectrum.Trends in utilization, diagnostic yield, and disease severity were evaluated for 4,048 consecutive initial CTPAs performed in adult patients in the emergency department of a large urban academic medical center between 1/1/2004 and 10/31/2009. Transthoracic echocardiography (TTE) findings and peak serum troponin levels were evaluated to assess for the presence of PE-associated right ventricular (RV) abnormalities (dysfunction or dilatation) and myocardial injury, respectively. Statistical analyses were performed using multivariate logistic regression.268 CTPAs (6.6%) were positive for acute PE, and 3,780 (93.4%) demonstrated either no PE or chronic PE. There was a significant increase in the likelihood of undergoing CTPA per year during the study period (odds ratio [OR] 1.05, 95% confidence interval [CI] 1.04-1.07, P<0.01). There was no significant change in the likelihood of having a CTPA diagnostic of an acute PE per year (OR 1.03, 95% CI 0.95-1.11, P = 0.49). The likelihood of diagnosing a less severe PE on CTPA with no associated RV abnormalities or myocardial injury increased per year during the study period (OR 1.39, 95% CI 1.10-1.75, P = 0.01).CTPA utilization has risen with no corresponding change in diagnostic yield, resulting in an increase in PE detection. There is a concurrent rise in the likelihood of diagnosing a less clinically severe spectrum of PEs.http://europepmc.org/articles/PMC3680477?pdf=render |
| spellingShingle | Andrew J Schissler Anna Rozenshtein Michal E Kulon Gregory D N Pearson Robert A Green Peter D Stetson David J Brenner Belinda D'Souza Wei-Yann Tsai Neil W Schluger Andrew J Einstein CT pulmonary angiography: increasingly diagnosing less severe pulmonary emboli. PLoS ONE |
| title | CT pulmonary angiography: increasingly diagnosing less severe pulmonary emboli. |
| title_full | CT pulmonary angiography: increasingly diagnosing less severe pulmonary emboli. |
| title_fullStr | CT pulmonary angiography: increasingly diagnosing less severe pulmonary emboli. |
| title_full_unstemmed | CT pulmonary angiography: increasingly diagnosing less severe pulmonary emboli. |
| title_short | CT pulmonary angiography: increasingly diagnosing less severe pulmonary emboli. |
| title_sort | ct pulmonary angiography increasingly diagnosing less severe pulmonary emboli |
| url | http://europepmc.org/articles/PMC3680477?pdf=render |
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