Purpose: To assess the percentage of computed tomography pulmonary angiography (CTPA) procedures that could have been avoided by methodical application of the Revised Geneva Score (RGS) coupled with age-adjusted D-dimer cut-offs rather than only clinical judgment in Emergency Department patients with suspected pulmonary embolism (PE). Material and methods: Between November 2019 and May 2020, 437 patients with suspected PE based on symptoms and D-dimer test were included in this study. All patients underwent to CTPA. For each patient, we retrospectively calculated the age-adjusted D-dimer cut-offs and the RGS in the original version. Finally, CT images were retrospectively reviewed, and the presence of PE was recorded. Results: In total, 43 (9.84%) CTPA could have been avoided by use of RGS coupled with age-adjusted D-dimer cut-offs. Prevalence of PE was 14.87%. From the analysis of 43 inappropriate CTPA, 24 (55.81%) of patients did not show any thoracic signs, two (4.65%) of patients had PE, and the remaining patients had alternative thoracic findings. Conclusion: The study showed good prevalence of PE diagnoses in our department using only physician assessment, although 9.84% CTPA could have been avoided by methodical application of RGS coupled with age-adjusted D-dimer cut-offs.

CT pulmonary angiography appropriateness in a single emergency department: does the use of revised Geneva score matter? / Mirabile, Alessandra; Lucarelli, Nicola Maria; Sollazzo, Enza Pia; Stabile Ianora, Amato Antonio; Sardaro, Angela; Mirabile, Gianmario; Lorusso, Filomenamila; Racanelli, Vito; Maggialetti, Nicola; Scardapane, Arnaldo. - In: LA RADIOLOGIA MEDICA. - ISSN 1826-6983. - 126:(2021), pp. 1544-1552. [10.1007/s11547-021-01416-x]

CT pulmonary angiography appropriateness in a single emergency department: does the use of revised Geneva score matter?

Racanelli, Vito;
2021-01-01

Abstract

Purpose: To assess the percentage of computed tomography pulmonary angiography (CTPA) procedures that could have been avoided by methodical application of the Revised Geneva Score (RGS) coupled with age-adjusted D-dimer cut-offs rather than only clinical judgment in Emergency Department patients with suspected pulmonary embolism (PE). Material and methods: Between November 2019 and May 2020, 437 patients with suspected PE based on symptoms and D-dimer test were included in this study. All patients underwent to CTPA. For each patient, we retrospectively calculated the age-adjusted D-dimer cut-offs and the RGS in the original version. Finally, CT images were retrospectively reviewed, and the presence of PE was recorded. Results: In total, 43 (9.84%) CTPA could have been avoided by use of RGS coupled with age-adjusted D-dimer cut-offs. Prevalence of PE was 14.87%. From the analysis of 43 inappropriate CTPA, 24 (55.81%) of patients did not show any thoracic signs, two (4.65%) of patients had PE, and the remaining patients had alternative thoracic findings. Conclusion: The study showed good prevalence of PE diagnoses in our department using only physician assessment, although 9.84% CTPA could have been avoided by methodical application of RGS coupled with age-adjusted D-dimer cut-offs.
2021
Mirabile, Alessandra; Lucarelli, Nicola Maria; Sollazzo, Enza Pia; Stabile Ianora, Amato Antonio; Sardaro, Angela; Mirabile, Gianmario; Lorusso, Filomenamila; Racanelli, Vito; Maggialetti, Nicola; Scardapane, Arnaldo
CT pulmonary angiography appropriateness in a single emergency department: does the use of revised Geneva score matter? / Mirabile, Alessandra; Lucarelli, Nicola Maria; Sollazzo, Enza Pia; Stabile Ianora, Amato Antonio; Sardaro, Angela; Mirabile, Gianmario; Lorusso, Filomenamila; Racanelli, Vito; Maggialetti, Nicola; Scardapane, Arnaldo. - In: LA RADIOLOGIA MEDICA. - ISSN 1826-6983. - 126:(2021), pp. 1544-1552. [10.1007/s11547-021-01416-x]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11572/386868
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