Recent developments in diagnostic imaging techniques and management for acute pulmonary embolism: multicenter registry by the Japanese Society of Pulmonary Embolism Research.
OBJECTIVE
There are many reports on the diagnosis and management of acute pulmonary embolism (APE), but there have been no investigations concerning the actual conditions in which recent developments in diagnostic imaging techniques and therapies have been applied in clinical practice. The present study was designed to investigate the changes in diagnostic imaging techniques and therapies for APE.


METHODS
Three hundred and nine APE patients diagnosed during January 1994-October 1997 (Group 1) were compared with 257 APE patients diagnosed during November 1997-October 2000 (Group 2) in terms of the diagnostic imaging techniques and therapies for APE.


RESULTS
Compared with Group 1, pulmonary angiography and contrast-enhanced computed tomography were more frequently performed for diagnosis in Group 2 [45.3% vs 56.8% (p = 0.0069) and 13.9% vs 57.6% (p < 0.0001), respectively]. Heparin and vena cava filter were used more often in Group 2 [74.4% vs 82.1% (p = 0.033) and 18.4% vs 33.9% (p < 0.0001), respectively]. The frequency of thrombolytic therapy was unchanged between the two groups. Warfarin use in discharged patients increased from 71.9% to 83.8% (p = 0.0022). However, the examination rates for deep vein thrombosis (DVT) were low (60.8% in Group 1 and 65.4% in Group 2, p = 0.29) and unchanged using any imaging techniques.


CONCLUSIONS
The diagnostic imaging techniques for APE increased in variety and the management has improved, while the diagnosis for DVT remains unchanged.
Sakuma
Masahito
M
Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai.
Okada
Osamu
O
Nakamura
Mashio
M
Nakanishi
Norifumi
N
Miyahara
Yoshiyuki
Y
Yamada
Norikazu
N
Fujioka
Hirofumi
H
Kuriyama
Takayuki
T
Kunieda
Takeyoshi
T
Sugimoto
Tsuneaki
T
Nakano
Takeshi
T
Shirato
Kunio
K
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D015331:Cohort Studies; D003287:Contrast Media; D003952:Diagnostic Imaging / Q000592:standards / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011336:Probability; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D011856:Radiographic Image Enhancement; D012042:Registries; D012106:Research; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D015912:Thrombolytic Therapy / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D016306:Vena Cava Filters
D003287:Contrast Media