The role of risk factors in delayed diagnosis of pulmonary embolism.
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.


CONCLUSIONS
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.
Ozsu
Savas
S
Department of Chest Diseases, Karadeniz Technical University, Trabzon, Turkey. savoz@mynet.com
Oztuna
Funda
F
Bulbul
Yilmaz
Y
Topbas
Murat
M
Ozlu
Tevfik
T
Kosucu
Polat
P
Ozsu
Asiye
A
D016009:Chi-Square Distribution; D057210:Delayed Diagnosis / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011652:Pulmonary Circulation; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013997:Time Factors; D014057:Tomography, X-Ray Computed