title: Timing of pulmonary embolism diagnosis in the emergency department.
abstract: BACKGROUND
  Patients with pulmonary embolism(PE) benefit from rapid diagnosis and treatment. The aim of the present study is to examine factors that contribute to the time between admission at the emergency department and diagnosis of PE (=time to diagnosis TTD).
  
  
  METHODS
  This retrospective study included 241 patients with symptomatic PE that were admitted at the emergency department. Patient records were reviewed to obtain the relevant clinical information. Patients were assigned in one of three groups according to their TTD: short TTD ≤ 2 h; intermediate TTD N 2 h and ≤ 12 h; and prolonged TTD N 12 h. The groups were compared for differences in clinical factors. Furthermore multiple linear regression analyses based on TTD was performed.
  
  
  RESULTS
  Factor that significantly contribute to a very short TTD b 2 h are tachycardia and a high embolus burden. Factors that significantly contribute to a diagnosis b12 h are embolus burden, no COPD present, patient admitted at day shift, and a less pathologic ratio of ventricle axis. Multiple regression analyses identified increased age and low embolus burden as the strongest, independent factors for prolonged TTD.
  
  
  CONCLUSIONS
  Patients with higher embolus load or signs of severe PE including tachycardia were most likely diagnosed within 2 h after presentation.More effort should be put in a faster diagnostic process in older patients and in patients with COPD.
authors.affiliation: Department of Radiology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle, Germany.
authors.forename: Andreas Gunter
authors.initials: AG
authors.lastname: Bach
authors.affiliation: Department of Radiology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle, Germany.
authors.forename: Rebecka
authors.initials: R
authors.lastname: Bandzauner
authors.affiliation: Department of Radiology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle, Germany.
authors.forename: Baasai
authors.initials: B
authors.lastname: Nansalmaa
authors.affiliation: Department of Radiology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle, Germany.
authors.forename: Nico
authors.initials: N
authors.lastname: Schurig
authors.affiliation: Department of Radiology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle, Germany.
authors.forename: Hans Jonas
authors.initials: HJ
authors.lastname: Meyer
authors.affiliation: Department of Internal Medicine, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle, Germany.
authors.forename: Bettina-Maria
authors.initials: BM
authors.lastname: Taute
authors.affiliation: Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger-Str. 8, 06112 Halle, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Wienke
authors.affiliation: Department of Radiology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle, Germany. Electronic address: alex.surow@medizin.uni-halle.de.
authors.forename: Alexey
authors.initials: A
authors.lastname: Surov
mesh_terms: D017677:Age Distribution; D000368:Aged; D000792:Angiography / Q000706:statistics & numerical data; D042241:Early Diagnosis; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D061665:Time-to-Treatment / Q000706:statistics & numerical data*; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014850:Waiting Lists
keywords: Computed tomography pulmonary angiography; Emergency department organization; Guideline; Pulmonary embolism; Time to diagnosis