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2015 to 2019 Saw Increase in ED Use of CTPA for Suspected Pulmonary Embolism

Increase in PE diagnosis and higher proportion of low-risk PEs, with lower proportion of ICU admissions

By Elana Gotkine HealthDay Reporter

TUESDAY, May 23, 2023 (HealthDay News) — From 2015 to 2019, there was an increase in the use of computed tomographic pulmonary angiography (CTPA) in the emergency department for suspected pulmonary embolism (PE), as well as an increase in diagnosed PEs, according to a study published online May 23 in the Annals of Internal Medicine.

Melanie Roussel, M.D., from Sorbonne Université in Paris, and colleagues conducted a retrospective analysis to measure the change in CTPA use for suspected PE in 26 European emergency departments in six countries. Data were included for patients with 8,970 CTPAs.

The researchers found that from 2015 to 2019, there were significant trends for more frequent use of CTPA (836 to 1,112 per 100,000 emergency department visits), more diagnosed PEs (138 versus 164 per 100,000), and a higher proportion of low-risk PEs (annual percent change [APC], 13.8 percent). In addition, there was an increase in ambulatory management (APC, 19.3 percent) and a lower proportion of intensive care unit admissions (APC, −8.9 percent).

“Many reports have associated the use of existing validated risk-assessments rules with a reduced use of CTPAs. That this study found something different raises several issues,” the authors write. “Maybe the clinician’s fear of missing a PE overrides the obvious benefits of following protocols and recommendations.”

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