Pulmonary embolism (PE) is a potentially lethal condition, and the diagnosis of PE can be difficult. The purpose of this study is to evaluate the incidence of PE on chest computed tomography angiography (CTA) studies ordered in the inpatient, outpatient, and emergency department (ED) settings and further segregated based on the adult and pediatric populations, and by the ordering clinician (attending physicians, resident physicians, or physician extenders). A retrospective review of chest CTA examinations performed between July 1,2009 and June 30, 2010 was performed. Of 5848 adult CTA studies, PE was diagnosed in 594 (10.1 %). Of these positive studies, 315 (53 %) were inpatient, 234 (39.4 %) were ED patients, and 45 (7.6 %) were outpatient. Four hundred sixty-four of 4445 (10.4 %) CTA examinations ordered by attending physicians were positive for PE. Seventy-four of the 801 (9.2 %) CTA examinations ordered by resident physicians were positive for PE. Fifty-six of the 608 CTA examinations ordered by physician extenders were positive for PE. Thirty-three pediatric CTA studies for PE met criteria and none of them indicated PE. There is no significant difference in the incidence of PE in chest CTA based on setting or ordering clinician.
Pulmonary embolism Computed tomography angiography Emergency medicine Inpatient Outpatient
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Conflict of interest
The authors declare that they have no conflict of interest.
Mamlouk MD, van Sonnenberg E, Gosalia R, Drachman D, Gridley D, Zamora JG, Casola G et al (2010) Pulmonary embolism at CT angiography: implications for appropriateness, cost, and radiation exposure in 2003 patients. Radiology 256(2):625–632CrossRefPubMedGoogle Scholar
Tuttle-Newhall JE, Rutledge R, Hultman CS, Fakhry SM (1997) Statewide, population-based, time-series analysis of the frequency and outcome of pulmonary embolus in 318,554 trauma patients. J Trauma 42(1):90–99CrossRefPubMedGoogle Scholar
Patel S, Kazerooni EA (2005) Helical CT for the evaluation of acute pulmonary embolism. AJR Am J Roentgenol 185(1):135–149CrossRefPubMedGoogle Scholar
Kline JA, Webb WB, Jones AE, Hernandez-Nino J (2004) Impact of a rapid rule-out protocol for pulmonary embolism on the rate of screening, missed cases, and pulmonary vascular imaging in an urban US emergency department. Ann Emerg Med 44(5):490–502CrossRefPubMedGoogle Scholar
Feied CF (1998) Pulmonary embolism. In: Rosen P, Barkin RM (eds) Emergency medicine principles and practice, 4th edn. Mosby-Year Book, St Louis, Mo, chap 111Google Scholar
Giuntini C, Di Ricco G, Marini C, Melillo E, Palla A. Pulmonary embolism: epidemiologyGoogle Scholar
Lee CH, Hankey GJ, Ho WK, Eikelboom JW (2005) Venous thromboembolism: diagnosis and management of pulmonary embolism. Med J Aust 182(11):569–574PubMedGoogle Scholar
Stein PD, Fowler SE, Goodman LR et al (2006) Multidetector computed tomography for acute pulmonary embolism. N Engl J Med 354(22):2317–2327CrossRefPubMedGoogle Scholar
Perrier A, Roy PM, Sanchez O et al (2005) Multidetector-row computed tomography in suspected pulmonary embolism. N Engl J Med 352(17):1760–1768CrossRefPubMedGoogle Scholar
van Belle A, Büller HR, Huisman MV et al (2006) Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D- dimer testing, and computed tomography. JAMA 295(2):172–179CrossRefPubMedGoogle Scholar