Pulmonary vascular disease & thromboembolism
Temporal Trends in the Use of Computed Tomographic Pulmonary Angiography for Suspected Pulmonary Embolism in the Emergency Department : A Retrospective Analysis
Authors' conclusion
Despite the recent validation of clinical decision rules to limit the use of CTPA, an increase in the CTPA rate along with more diagnosed PEs and especially low-risk PEs were instead observed.
Study context
- Population
- Patients with computed tomographic pulmonary angiography (CTPA) for suspected pulmonary embolism (PE) in the emergency department (ED), first 7 days of each odd month, January 2015–December 2019
- Participants
- 8,970 CTPAs
- Exposure
- Temporal trends 2015 vs 2019
- Outcome
- CTPAs for suspected PE in the ED and PEs diagnosed in the ED per year, adjusted to an annual census of 100 000 ED visits
Methodological detailsmulticentre, 26 European EDs in 6 countries, Data limited to 7 days every 2 months
- Multicentre
- 26 European EDs in 6 countries
- Data limited to 7 days every 2 months
Main finding
As reported in the abstract
| Group | CTPA use | Diagnosed PEs |
|---|---|---|
| 2015 | 836 per 100 000 ED visits | 138 per 100 000 |
| 2019 | 1112 | 164 |
CTPA use
2015836 per 100 000 ED visits
20191112
Diagnosed PEs
2015138 per 100 000
2019164
- 2019 vs 2015: P < 0.001 — CTPA use
- 2019 vs 2015: P = 0.028 — diagnosed PEs
Observational data: associations, not effects.
Further findings
Proportion of low-risk PEs
- Annual percent change
- 13.8% (95% CI 2.6% to 30.1%)
Ambulatory management
- Annual percent change
- 19.3% (CI 4.1% to 45.1%)
Proportion of ICU admissions
- Annual percent change
- −8.9% (CI −17.1% to −0.3%)
Original publication
Temporal Trends in the Use of Computed Tomographic Pulmonary Angiography for Suspected Pulmonary Embolism in the Emergency Department : A Retrospective Analysis. Ann Intern Med. Published 23 May 2023. doi:10.
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