title: Computed tomography pulmonary angiography in the diagnosis of acute pulmonary embolism in the emergency department.
abstract: This study was undertaken to evaluate the use of computed tomography pulmonary angiography (CTPA) in patients with pulmonary embolism (PE) who were followed in the emergency department (ED). The files and computer records of 850 patients older than 16 years of age who were seen in the Hacettepe University Hospital ED between April 10, 2001, and December 1, 2005, and who required CTPA for PE prediagnosis and/or another diagnosis, were studied retrospectively. PE was identified by CTPA in 9.4% of 416 women and in 5.8% of 434 men. A significant difference (P<.05) was noted in the women and men in whom PE was detected. The mean age of the patients was 58.13+/-17.88 y (range, 16-100 y). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for clinical susceptibility to PE among patients who underwent CTPA were assessed at 95.3%, 48.2%, 13%, and 99.2%, respectively. CTPA was done for different reasons: aortic aneurysm dissection (n=1), cough distinctive diagnosis (n=1), dyspnea distinctive diagnosis (n=6), chest pain distinctive diagnosis (n=3), PE prediagnosis (n=51), and other reasons (n=2). Also, sensitivity, specificity, PPV, and NPV were found to be 95.4%, 16.2%, 14.4%, and 96%, respectively, for D-dimer. CTPA, which is accessible on a 24-h basis in the ED, is a valuable tool for the diagnosis of PE.
authors.affiliation: Department of Emergency Medicine, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
authors.forename: Mucahit
authors.initials: M
authors.lastname: Emet
authors.forename: Dogac Niyazi
authors.initials: DN
authors.lastname: Ozucelik
authors.forename: Mahir
authors.initials: M
authors.lastname: Sahin
authors.forename: Munci
authors.initials: M
authors.lastname: Oran
authors.forename: Bulent
authors.initials: B
authors.lastname: Sivri
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012737:Sex Factors; D036542:Tomography, Spiral Computed