Utilization patterns and diagnostic yield of 3421 consecutive multidetector row computed tomography pulmonary angiograms in a busy emergency department.

Abstract:

OBJECTIVE:To compare examination volume and diagnostic yield of computed tomography (CT) pulmonary angiography (CTPA) and ventilation-perfusion (V/Q) scintigraphy for detection of suspected pulmonary embolism (PE) in emergency department patients. METHODS:Every CTPA and V/Q scan result for emergency department patients between October 2001 and September 2005 were reviewed. Patients with prior PE and follow-up examinations were excluded. RESULTS:A total of 3421 CTPA examinations and 198 V/Q scans met inclusion criteria. Average CTPA examinations completed per month increased 227%, from 33.4 to 109.2 for the first and last 24-month periods, respectively. Ventilation-perfusion scintigraphy volume decreased 80% (from 6.9 to 1.4 per month). Total diagnoses of PE per month increased 89% from 4.0 to 7.5, whereas the percentage of positive CTPA examinations dropped from 9.8% to 6.8%. CONCLUSIONS:Availability of CT in the emergency department and lower physician thresholds for test utilization have increased the use of CT pulmonary angiography and increased detection of PE.

journal_name

J Comput Assist Tomogr

authors

Donohoo JH,Mayo-Smith WW,Pezzullo JA,Egglin TK

doi

10.1097/RCT.0b013e31812e6af3

subject

Has Abstract

pub_date

2008-05-01 00:00:00

pages

421-5

issue

3

eissn

0363-8715

issn

1532-3145

pii

00004728-200805000-00018

journal_volume

32

pub_type

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