RT Journal Article
T1 Patient-Level, Institutional, and Temporal Variations in Use of Imaging Modalities to Confirm Pulmonary Embolism.
A1 Mehdipoor, Ghazaleh
A1 Jimenez, David
A1 Bertoletti, Laurent
A1 Fidalgo, Ángeles
A1 Sanchez Muñoz-Torrero, Juan Francisco
A1 Gonzalez-Martinez, José Pedro
A1 Blanco-Molina, Ángeles
A1 Ángel Aibar, Miguel
A1 Bonnefoy, Pierre-Benoît
A1 Khorasani, Ramin
A1 Prince, Martin R
A1 Bikdeli, Behnood
A1 Monreal, Manuel
A1 RIETE Investigators, 
K1 angiography
K1 computed tomography angiography
K1 pulmonary embolism
K1 thrombosis
K1 ultrasonography
K1 ventilation-perfusion scan
AB The choice of the imaging modality for diagnosis of pulmonary embolism (PE) could be influenced by provider, patient or hospital characteristics, or over time. However, little is known about the choice of the diagnostic modalities in practice. The aim of this study was to evaluate the variations in the use of imaging modalities for patients with acute PE. Using the data from Registro Informatizado Enfermedad TromboEmbolica (RIETE), a prospective international registry of patients with venous thromboembolism (March 2001-January 2019), we explored the imaging modalities used in patients with acute PE. The imaging modalities included computed tomography pulmonary angiography, ventilation/perfusion scanning, pulmonary angiography, a combination of these tests, or PE signs and symptoms plus imaging-confirmed proximal deep vein thrombosis but no chest imaging. Among 38 025 patients with confirmed PE (53.1% female, age: 67.3±17 years), computed tomography pulmonary angiography was the dominant modality of diagnosis in all RIETE enrollees (78.2% [99% CI, 77.6-78.7]); including pregnant patients (58.9% [99% CI, 47.7%-69.4%]) and patients with severe renal insufficiency (62.5% [99% CI, 59.9-65.0]). A greater proportion of patients underwent ventilation/perfusion scanning in larger hospitals compared with smaller hospitals (13.1% versus 7.3%, P In a large multinational PE registry, variations were observed in the use of imaging modalities according to patient or institutional factors and over time. However, computed tomography pulmonary angiography was the dominant modality of diagnosis, even in pregnancy and severe renal insufficiency. The safety, costs, and downstream effects of these tests on PE-related and non-PE-related outcomes warrant further investigation.
YR 2020
FD 2020-05-16
LK http://hdl.handle.net/10668/15579
UL http://hdl.handle.net/10668/15579
LA en
DS RISalud
RD Apr 7, 2025