Optimization of the diagnostic management of clinically suspected pulmonary embolism in hospitalized patients

Tom van der Hulle; Paul L. den Exter; Inge C. M. Mos; Pieter W. Kamphuisen; Marcel M. C. Hovens; Marieke J. H. A. Kruip; Josien van Es; Hugo ten Cate; Menno V. Huisman; Frederikus A. Klok

doi:10.1111/bjh.13090

Optimization of the diagnostic management of clinically suspected pulmonary embolism in hospitalized patients

Tom van der Hulle^*, Paul L. den Exter, Inge C. M. Mos, Pieter W. Kamphuisen, Marcel M. C. Hovens, Marieke J. H. A. Kruip, Josien van Es, Hugo ten Cate, Menno V. Huisman, Frederikus A. Klok

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Identical diagnostic algorithms for suspected pulmonary embolism (PE) are used for hospitalized patients and outpatients, while D-dimer levels, risk factors and pre-test probability for PE differ, and the percentage of patients managed without computerized tomography pulmonary angiography (CTPA) is lower in hospitalized patients. We aimed to improve the efficiency of the diagnostic algorithm by increasing the threshold of the D-dimer, the threshold of the Wells rule and by adjustments of the Wells rule. Six-hundred and twenty-four hospitalized patients from two previously performed management studies with a PE prevalence of 26% were studied. Adjustments were considered to be safe when the failure rate remained

Original language	English
Pages (from-to)	681-686
Journal	British Journal of Haematology
Volume	167
Issue number	5
DOIs	https://doi.org/10.1111/bjh.13090
Publication status	Published - Dec 2014

Keywords

pulmonary embolism
inpatients
diagnoses
fibrin-fibrinogen degradation products
multidetector computerized tomography

Access to Document

10.1111/bjh.13090

Cite this

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title = "Optimization of the diagnostic management of clinically suspected pulmonary embolism in hospitalized patients",

abstract = "Identical diagnostic algorithms for suspected pulmonary embolism (PE) are used for hospitalized patients and outpatients, while D-dimer levels, risk factors and pre-test probability for PE differ, and the percentage of patients managed without computerized tomography pulmonary angiography (CTPA) is lower in hospitalized patients. We aimed to improve the efficiency of the diagnostic algorithm by increasing the threshold of the D-dimer, the threshold of the Wells rule and by adjustments of the Wells rule. Six-hundred and twenty-four hospitalized patients from two previously performed management studies with a PE prevalence of 26% were studied. Adjustments were considered to be safe when the failure rate remained ",

keywords = "pulmonary embolism, inpatients, diagnoses, fibrin-fibrinogen degradation products, multidetector computerized tomography",

author = "{van der Hulle}, Tom and {den Exter}, {Paul L.} and Mos, {Inge C. M.} and Kamphuisen, {Pieter W.} and Hovens, {Marcel M. C.} and Kruip, {Marieke J. H. A.} and {van Es}, Josien and {ten Cate}, Hugo and Huisman, {Menno V.} and Klok, {Frederikus A.}",

year = "2014",

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doi = "10.1111/bjh.13090",

language = "English",

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pages = "681--686",

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T1 - Optimization of the diagnostic management of clinically suspected pulmonary embolism in hospitalized patients

AU - van der Hulle, Tom

AU - den Exter, Paul L.

AU - Mos, Inge C. M.

AU - Kamphuisen, Pieter W.

AU - Hovens, Marcel M. C.

AU - Kruip, Marieke J. H. A.

AU - van Es, Josien

AU - ten Cate, Hugo

AU - Huisman, Menno V.

AU - Klok, Frederikus A.

PY - 2014/12

Y1 - 2014/12

N2 - Identical diagnostic algorithms for suspected pulmonary embolism (PE) are used for hospitalized patients and outpatients, while D-dimer levels, risk factors and pre-test probability for PE differ, and the percentage of patients managed without computerized tomography pulmonary angiography (CTPA) is lower in hospitalized patients. We aimed to improve the efficiency of the diagnostic algorithm by increasing the threshold of the D-dimer, the threshold of the Wells rule and by adjustments of the Wells rule. Six-hundred and twenty-four hospitalized patients from two previously performed management studies with a PE prevalence of 26% were studied. Adjustments were considered to be safe when the failure rate remained

AB - Identical diagnostic algorithms for suspected pulmonary embolism (PE) are used for hospitalized patients and outpatients, while D-dimer levels, risk factors and pre-test probability for PE differ, and the percentage of patients managed without computerized tomography pulmonary angiography (CTPA) is lower in hospitalized patients. We aimed to improve the efficiency of the diagnostic algorithm by increasing the threshold of the D-dimer, the threshold of the Wells rule and by adjustments of the Wells rule. Six-hundred and twenty-four hospitalized patients from two previously performed management studies with a PE prevalence of 26% were studied. Adjustments were considered to be safe when the failure rate remained

KW - pulmonary embolism

KW - inpatients

KW - diagnoses

KW - fibrin-fibrinogen degradation products

KW - multidetector computerized tomography

U2 - 10.1111/bjh.13090

DO - 10.1111/bjh.13090

M3 - Article

C2 - 25146098

SN - 0007-1048

VL - 167

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EP - 686

JO - British Journal of Haematology

JF - British Journal of Haematology

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