title: Occult pulmonary embolism in intensive care unit patients undergoing chest computed tomography scan: incidence and effect on outcomes.
abstract: OBJECTIVE
  To determine the incidence of occult pulmonary embolism (PE) and the associated morbidity in an intensive care unit (ICU).
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Fifteen-bed ICU of a university hospital.
  
  
  METHODS
  Two hundred patients who underwent chest computed tomography (CT) scans with administration of contrast.
  
  
  METHODS
  The patients were classified into 3 groups: (1) Occult PE if the chest CT scan was not taken, specifically for elucidating the diagnosis of PE, but it confirmed this diagnosis; (2) non-occult PE if the chest CT scan was taken to elucidate a suspected diagnosis of PE and confirmed this diagnosis; and (3) the chest CT scan did not confirm this diagnosis. The analysis was conducted to identify the effect of a diagnosis of occult PE on the outcomes of patients.
  
  
  RESULTS
  Among the 200 patients who underwent chest CT scan, 27 (13%) patients had PE, in whom 18 (9%) were classified as occult PE and 9 (4.5%) as non-occult PE. The duration of ICU stay was increased in patients with PE, as compared with the controls (23 [18-48] days v 17 [10-20] days v 14 [7-29] days; p = 0.02 for occult PE, non-occult PE, and controls, respectively). No difference was observed in mortality rate among the 3 groups.
  
  
  CONCLUSIONS
  Occult PE was found in 9% of the cohort. This emphasized the need for developing diagnostic strategies in high-risk patients. Future studies should aim at assessing interventions for preventing this event.
authors.affiliation: Service d'Anesthésie et de Réanimation, Assistance Publique Hôpitaux de Marseille, Hôpital Nord, Aix Marseille Université, Marseille, France.
authors.forename: Elodie
authors.initials: E
authors.lastname: Arnoult
authors.forename: Sandrine
authors.initials: S
authors.lastname: Wiramus
authors.forename: Julien
authors.initials: J
authors.lastname: Textoris
authors.forename: Fabien
authors.initials: F
authors.lastname: Craighero
authors.forename: Benoit
authors.initials: B
authors.lastname: Ragonnet
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Hammad
authors.forename: Kathia
authors.initials: K
authors.lastname: Chaumoître
authors.forename: Claude
authors.initials: C
authors.lastname: Martin
authors.forename: Marc
authors.initials: M
authors.lastname: Leone
mesh_terms: D000328:Adult; D000368:Aged; D019090:Case Management; D015331:Cohort Studies; D003422:Critical Care / Q000379:methods*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000009:adverse effects* / Q000379:methods*; D016896:Treatment Outcome