Document Detail

Associations between Presence of Relevant Information in Referrals to Radiology and Prevalence Rates in Patients with Suspected Pulmonary Embolism.
MedLine Citation:
PMID:  23931425     Owner:  NLM     Status:  In-Data-Review    
RATIONALE AND OBJECTIVES: The purpose of this study was to assess if the presence of information including the pretest probability (Wells score), other known risk factors, and symptoms given on referrals for computed tomography (CT) pulmonary angiography correlated with prevalence rates for pulmonary embolism (PE). Also, to evaluate for differences between a university and a regional hospital setting regarding patient characteristics, amount of relevant information provided on referrals, and prevalence rates for pulmonary embolism.
MATERIALS AND METHODS: Retrospective review of all consecutive referrals (emergency room, inpatient, and outpatient) for CT performed on children and adults for suspected PE from two sites: a tertiary (university) hospital (site 1) and a secondary (regional) hospital (site 2) over a 5-year period.
RESULTS: The overall prevalence rate was 510/3641 or14% of all referrals. Significantly higher number of males had a positive CT compared to women (18% versus 12%, P < .001). Although no statistically significant relationship between a greater amount of relevant information on the referral and the probability for positive finding existed, a slight trend was noted (P = .09). In two categories, "hypoxia" and "signs of deep vein thrombosis," the presence of this information conferred a higher probability for pulmonary embolism, P < .001. In the categories, "chest pain," "malaise," and "smoker/chronic obstructive pulmonary disease", the absence of information conferred a higher probability for pulmonary embolism.
CONCLUSIONS: The amount of relevant clinical information on the request did not correlate with prevalence rates, which may reflect a lack of documentation on the part of emergency physicians who may use a "gestalt" approach. Request forms likely did not capture all relevant patient risks and many factors may interact with each other, both positively and negatively. Pretest probability estimations were rarely performed, despite their inclusion in major society guidelines.
Charlotta Hedner; Pia C Sundgren; Aine Marie Kelly
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Academic radiology     Volume:  20     ISSN:  1878-4046     ISO Abbreviation:  Acad Radiol     Publication Date:  2013 Sep 
Date Detail:
Created Date:  2013-08-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9440159     Medline TA:  Acad Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1115-21     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.
Center for Medical Imaging and Physiology, Skåne University Hospital, Lund University, Lund, Sweden.
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