Document Detail


The role of risk factors in delayed diagnosis of pulmonary embolism.
MedLine Citation:
PMID:  20825770     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Despite diagnostic advances, delays in the diagnosis of pulmonary embolism (PE) are common.
OBJECTIVE: In this study, we aimed to investigate the relationship between delays in the diagnosis of PE and underlying risk factors for PE.
METHODS: We retrospectively evaluated the records of 408 patients with acute PE. Patients were divided into 2 groups, surgical or medical, based on risk factors leading to the embolism. Analysis involved demographic characteristics of the patients, dates of symptom onset, first medical evaluation, and confirmatory diagnostic tests. Diagnostic delay was described as diagnosis of PE more than 1 week after symptom onset.
RESULTS: The mean time to diagnosis for all patients was 6.95 ± 8.5 days (median, 3 days; range, 0-45 days). Of the total number of patients, 29.6% had presented within the first 24 hours and 72.3% within the first week. The mean time to diagnosis was 4.4 ± 7.6 days (median, 2 days; range, 0-45 days) in the surgical group and 8.0 ± 8.6 days (median, 4 days; range, 0-45 days) in the medical group (P = .000). The mean time to diagnosis in the medical group was approximately 4 times greater than that of the surgical group on univariate analysis. Early or delayed diagnosis had no significant impact on mortality in either group.
CONCLUSION: Delay in the diagnosis of PE is an important issue, particularly in medical patients. We suggest that a public health and educational initiative is needed to improve efficiency in PE diagnosis.
Authors:
Savas Ozsu; Funda Oztuna; Yilmaz Bulbul; Murat Topbas; Tevfik Ozlu; Polat Kosucu; Asiye Ozsu
Publication Detail:
Type:  Journal Article     Date:  2010-03-09
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  29     ISSN:  1532-8171     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-07     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  26-32     Citation Subset:  IM    
Copyright Information:
Crown Copyright © 2011. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Chest Diseases, Karadeniz Technical University, Trabzon, Turkey. savoz@mynet.com
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MeSH Terms
Descriptor/Qualifier:
Chi-Square Distribution
Delayed Diagnosis / statistics & numerical data
Female
Humans
Logistic Models
Male
Middle Aged
Pulmonary Circulation
Pulmonary Embolism / diagnosis*,  etiology,  radiography
Retrospective Studies
Risk Factors
Statistics, Nonparametric
Time Factors
Tomography, X-Ray Computed

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