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Risk of pulmonary embolism after a prior negative CT pulmonary angiogram.
Hammer, Mark M; Litt, Harold I.
Afiliação
  • Hammer MM; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Litt HI; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Electronic address: Harold.Litt@uphs.upenn.edu.
Am J Emerg Med ; 34(10): 1968-1972, 2016 Oct.
Article em En | MEDLINE | ID: mdl-27435874
CONTEXT: With increasing utilization of computed tomography pulmonary angiography (CTPA) for the diagnosis of pulmonary embolism (PE), many patients undergo repeat CTs. OBJECTIVE: The aim of this study is to identify the rate of positive subsequent CTPAs after an initial negative CTPA and whether there is a risk-free period after a negative CTPA. METHODS: We evaluated 318 patients with at least 1 subsequent CTPA after an initial negative CTPA, with 786 total CTPAs. We also evaluated a control group of 200 unselected CTPAs. RESULTS: The positive rate in the repeat group was 7% at the first repeat CTPA and 10% per-patient within 1000 days. The positive rate in the control group was 9% (P= not significant). No risk-free period was seen, with a positive rate of 5% within 2 weeks after a negative CTPA. The number of prior negative CTPAs showed a trend towards decreasing rate of the subsequent CTPA being positive, but this did not meet statistical significance. DISCUSSION: There is no risk-free period after an initial negative CTPA, and therefore, patients with clinical suspicion of PE should be rescanned even after a recent negative study. Even patients with multiple negative prior CTPAs have a measurable risk of subsequent PE. Established clinical prediction scoring systems must be used to triage the patients who need CTPAs.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Embolia Pulmonar Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Emerg Med Ano de publicação: 2016 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Embolia Pulmonar Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Emerg Med Ano de publicação: 2016 Tipo de documento: Article País de publicação: Estados Unidos