Adherence to the algorithmic approach for diagnosis of pulmonary embolism: A teaching hospital experience, Shiraz, Iran

Publish Year: 1399
نوع سند: مقاله ژورنالی
زبان: English
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شناسه ملی سند علمی:

JR_RYA-16-5_002

تاریخ نمایه سازی: 2 شهریور 1401

Abstract:

BACKGROUND: We evaluated to see if the algorithmic approach of pulmonary embolism (PE) [Wells’ score, followed by D-dimer test and computed tomography pulmonary angiography (CTPA)] is appropriately followed in teaching hospitals of Shiraz, Iran.METHODS: From October ۲۰۱۲ to October ۲۰۱۳, we prospectively calculated Wells’ score for all patients who underwent CTPA with clinical suspicion to PE; patients with low probability who had not checked the D-dimer or had low level of D-dimer were considered as non-adherent to the guideline and those with high level of D-dimer or high probability of Wells’ score were labeled as adherent to the PE guideline. CTPA scans were independently reported by two radiologists.RESULTS: During study period, ۳۶۴ patients underwent CTPA to rule out PE, of which ۱۲۵ (۳۴.۳%) had Wells’ score > ۴ (high probable risk) and ۲۳۹ had Wells’ score ≤ ۴. Amongst low probable risk patients (Wells’ score ≤ ۴), only ۳۲ patients had undergone the D-dimer test (۲۳ patients had high level of D-dimer). Based on the algorithmic approach, patients with suspected PE, patients with high probability (۱۲۵ patients), and patients with low probability with elevated D-dimer level (۲۳ patients) were considered as adherent to the PE guideline; consequently, the total adherence to PE guideline was ۱۴۸ out of ۳۶۴ (۴۰.۶%).CONCLUSION: We followed the algorithmic approach guideline in about ۴۰.۰% of cases; however, we should pay more attention to the algorithmic approach in patients with suspected PE.

Authors

Vahid Mohammadkarimi

Assistant Professor, Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

Samaneh Ahsant

Resident, Student Research Committee AND Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

Mohammad Hadi Bagheri

Professor, Medical Imaging Research Center AND Department of Radiology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

Reza Jalli

Associate Professor, Medical Imaging Research Center AND Department of Radiology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

Ali Hosseinipour

Assistant Professor, Non-Communicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran

Seyed Masoom Masoompour

Professor, Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

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