RT Journal Article
SR Electronic
T1 (Contributing factors to) the diagnostic yield of CT pulmonary angiography: A retrospective study
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3889
VO 40
IS Suppl 56
A1 Minke Alie Leijstra
A1 Stefan Walen
A1 Steven M. Uil
A1 Martijn F. Boomsma
A1 Jan Willem K. van den Berg
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P3889.abstract
AB IntroductionPulmonary embolism (PE) is a potentially life-threatening disease which requires quick and reliable diagnosis to start timely treatment. Clinical probability of pulmonary embolism is assessed by using a combination of Wells-score and D-dimer level. In most cases of PE, CT of pulmonary arteries (CTPA) provides a reliable diagnosis. In the Isala klinieken approximately 1000 CTPAs are performed annually, but its diagnostic yield and factors associated with improving it are unknown. In literature diagnostic yield varies from 7-31%.AimsTo determine diagnostic yield of CTPA in our centre and factors associated with it. Differences between specialities as well as adherence to protocol were investigated.MethodsAll patients receiving a first CTPA for pulmonary embolism in 2010 were included. Data about relevant clinical information and requesting speciality were retrospectively obtained. Differences in diagnostic yield were tested using a Chi-square test. Independent predictors were identified with multivariate logistic regression.ResultsPE on CTPA was found in 224 of the 974 patients (23%). Between specialities, diagnostic yield varied from 19.5-23.9% (p=0,20). Independent predictors of diagnostic yield were: age, sex, D-dimer, chest pain, cough, dyspnea, cardiac history, COPD, atelectasis/consolidation, intrapulmonary mass and/or interstitial pulmonary disease on CT. Wells-scores were poorly documented (n=127, 13.1%). Poor adherence to protocol was also shown by a high amount of unnecessary D-dimer values with a high Wells-score (35 of 58; 58.6%).ConclusionsThe diagnostic yield of CTPA in this study was relatively high. Better adherence to protocol might improve it further.