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 journalArticleAcademicpeer-review

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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 languageEnglish
Pages (from-to)681-686
JournalBritish Journal of Haematology
Issue number5
Publication statusPublished - Dec 2014


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

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