| Pulmonary embolism incidence is increasing with use of spiral computed tomography. | |
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MedLine Citation:
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PMID: 18589057 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Pulmonary embolism causes significant morbidity in hospitalized patients, yet few studies have explored the impact of spiral computed tomography (CT) scanning on diagnosis and clinical outcome. METHODS: Incidence rates of pulmonary embolism, chest and spiral CT rates, D-dimer assay, anticoagulation, and in-hospital mortality were assessed on statewide pulmonary embolism discharge data (1997-2001) from the Pennsylvania Health Care Cost Containment Council. RESULTS: The incidence of pulmonary embolism increased from 47 to 63 per 100,000 patients from 1997 to 2001 (mean of 0.004% per year, P < .001). Mean pulmonary embolism incidence rates were higher for African American patients (0.031% per year higher than for white patients), patients aged 70 years or more (0.007% higher than for patients aged<70 years), and female patients (0.013% higher than for male patients) (all P < .001). Concomitantly, the proportion undergoing CT (including spiral) scans increased from 23.23% to 45.18% (odds ratio=1.30; P<.001), controlling for age, gender, race, and cancer, whereas rates for other procedures remained unchanged. By comparing 1999 and before with 2000 and after, there was a significant decrease in the 2 highest Atlas Severity of Illness categories (49.4%-37.7%) and a significant increase in the 3 lowest categories (50.6%-62.3%; P < .001). The risk of in-hospital deaths among patients with pulmonary embolism decreased in this period from 12.8% to 11.1% (P < .001). CONCLUSION: The incidence of pulmonary embolism is increasing with the increasing use of spiral CT scans, with a lower severity of illness and lower mortality, suggesting the increase is due to earlier diagnosis. |
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Authors:
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Nicholas A DeMonaco; Qianyu Dang; Wishwa N Kapoor; Margaret V Ragni |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The American journal of medicine Volume: 121 ISSN: 1555-7162 ISO Abbreviation: Am. J. Med. Publication Date: 2008 Jul |
Date Detail:
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Created Date: 2008-06-30 Completed Date: 2008-07-29 Revised Date: 2012-10-09 |
Medline Journal Info:
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Nlm Unique ID: 0267200 Medline TA: Am J Med Country: United States |
Other Details:
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Languages: eng Pagination: 611-7 Citation Subset: AIM; IM |
Affiliation:
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Division of Hematology/Oncology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Age Distribution Aged Continental Population Groups / statistics & numerical data Female Fibrin Fibrinogen Degradation Products / analysis Hospital Mortality Humans Incidence Male Patient Discharge / statistics & numerical data, trends Pennsylvania / epidemiology Pulmonary Embolism / diagnosis*, epidemiology* Risk Factors Severity of Illness Index Sex Distribution Tomography, Spiral Computed / utilization* |
| Grant Support | |
ID/Acronym/Agency:
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UL1 RR024153/RR/NCRR NIH HHS; UL1 RR024153-01/RR/NCRR NIH HHS |
| 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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Am J Med. 2008 Dec;121(12):e17; author reply e19
[PMID:
19028183
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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