title: Examination of hospital referral practices for CT pulmonary angiography.
abstract: Guidelines for the evaluation of venous thromboembolism (VTE) include a history and physical examination in conjunction with computed tomographic pulmonary angiography (CTPA), Doppler ultrasonography, and D-dimer measurements. We performed a retrospective analysis to evaluate the diagnostic yield of CTPA at our facility. Patients between the ages of 18 and 100 with a CTPA completed through the emergency department and/or any inpatient service over a 6-month period were reviewed and a retrospective Simplified Wells Score was calculated. Three hundred and three patients underwent CTPA for acute VTE. A Simplified Wells Score was calculated for 279 subjects, with a mean score of 1.6 +/- 1.6. Twenty CTPA procedures demonstrated VTE, a positive rate of 7.2%, which was lower than expected. This result likely reflects lack of adherence to a clinical algorithm for assessment of VTE and an overly cautious approach to symptom evaluation.
authors: Madigan Army Medical Center. cristin.kiley@us.army.mil
authors: Cristin A
authors: CA
authors: Kiley
authors: Kristie J
authors: KJ
authors: Lowry
authors: Vincent
authors: V
authors: Mysliwiec
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013923:Thromboembolism / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed