Are Diagnostic Algorithms for Suspected Pulmonary Embolism Applicable in French Emergency Departments?
Abstract number: P1049
Roy1 PM, Furber1 A, Roupie2 E, Honnart3 D, Soulat4 L, Meyer5 G
11University hospital of Angers, Angers, France 11University hospital of Angers, Angers, France 22University hospital Henry Mondor, Créteil, France 33University hospital of Dijon, Dijon, France 44General hospital of Chateauroux, Chateauroux, France 55University hospital Georges Pompidou, Paris, France
Aims: To assess the applicability of diagnostic strategies for pulmonary embolism suspicion whether they are based on V/Q scan or on spiral CT.
Methods: A questionnaire was send to the physician in charge of the Emergency Department of the 492 French public hospitals. We obtained 261 answers (53%).
Results: A strategy based on D-dimer, venous ultrasonography and spiral CT was applicable at working hours in 64% of the centres as compared to 23% for a strategy based on D-dimer, venous ultrasonography and lung scan (P < 0.001). All the centres that had V/Q scan or pulmonary angiography facility had spiral CT facility too, 11% of the centres had access to spiral CT but had no venous ultrasonography facility, 13% had venous ultrasonography facility but no spiral CT, and 11% had no venous ultrasonography and no spiral CT facility. D-dimer test was available in 98% of the centres and 83% declared performing a D-dimer test in all patients with suspected pulmonary embolism. A written diagnostic algorithm was available in 44 centres (17%) and a clinical probability rule in 34 centres (13%).
Conclusion: Since the advent of spiral CT, the majority of patients who seek emergency care with suspected pulmonary embolism in France can benefit from a valid non-invasive diagnostic strategy. However, the lack of local guidelines may hamper a proper diagnostic management as suggested by the high rate of D-dimer testing systematically performed.
To cite this abstract use the following format:
Journal of Thrombosis and Haemostasis 2005; Volume 3, Supplement 1: abstract number
|Session name:||XXIst ISTH Congress|
|Subject:||Posters Session Tuesday|
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