| Noninvasive diagnosis of pulmonary embolism. | |
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MedLine Citation:
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PMID: 20724733 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: We designed a simple and integrated diagnostic algorithm for acute pulmonary embolism (PE). Diagnosis was based on clinical probability assessment, plasma D-dimer testing, then sequential testing to include lower limb venous compression ultrasonography, ventilation perfusion lung scan, and chest multidetector CT (MDCT) imaging. METHODS: We included 321 consecutive patients presenting at Brest University Hospital in Brest, France, with clinically suspected PE and positive d-dimer or high clinical probability. Patients in whom VTE was deemed absent were not given anticoagulants and were followed up for 3 months. RESULTS: Detection of DVT by ultrasonography established the diagnosis of PE in 43 (13%). Lung scan associated with clinical probability was diagnostic in 243 (76%) of the remaining patients. MDCT scan was required in only 35 (11%) of the patients. The 3-month thromboembolic risk in patients not given anticoagulants, based on the results of the diagnostic protocol, was 0.53% (95% CI, 0.09-2.94). CONCLUSIONS: A diagnostic strategy combining clinical assessment, d-dimer, ultrasonography, and lung scan gave a noninvasive diagnosis in the majority of outpatients with suspected PE and appeared to be safe. |
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Authors:
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Pierre-Yves Salaun; Francis Couturaud; Alexandra Le Duc-Pennec; Karine Lacut; Pierre-Yves Le Roux; Philippe Guillo; Pierre-Yves Pennec; Jean-Christophe Cornily; Christophe Leroyer; Grégoire Le Gal |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't Date: 2010-08-19 |
Journal Detail:
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Title: Chest Volume: 139 ISSN: 1931-3543 ISO Abbreviation: Chest Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-06-09 Completed Date: 2011-09-22 Revised Date: 2011-12-08 |
Medline Journal Info:
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Nlm Unique ID: 0231335 Medline TA: Chest Country: United States |
Other Details:
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Languages: eng Pagination: 1294-8 Citation Subset: AIM; IM |
Affiliation:
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Université Européenne de Bretagne, Brest, France. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Algorithms Angiography Cohort Studies Enzyme-Linked Immunosorbent Assay Fibrin Fibrinogen Degradation Products / metabolism Humans Middle Aged Perfusion Imaging Prognosis Pulmonary Embolism / blood, diagnosis*, therapy Tomography, X-Ray Computed Ventilation-Perfusion Ratio |
| Chemical | |
Reg. No./Substance:
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0/Fibrin Fibrinogen Degradation Products; 0/fibrin fragment D |
| Comments/Corrections | |
Comment In:
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Chest. 2011 Nov;140(5):1391; author reply 1391-2
[PMID:
22045890
]
Chest. 2011 Jun;139(6):1264-6 [PMID: 21652552 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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