PT  - JOURNAL ARTICLE
AU  - Minke Alie Leijstra
AU  - Stefan Walen
AU  - Steven M. Uil
AU  - Martijn F. Boomsma
AU  - Jan Willem K. van den Berg
TI  - (Contributing factors to) the diagnostic yield of CT pulmonary angiography: A retrospective study
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - P3889
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/P3889.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/P3889.full
SO  - Eur Respir J2012 Sep 01; 40
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.