Journal article
Pulmonary embolism rule out: positivity and factors affecting the yield of CT angiography
Postgraduate medical journal, Vol.96(1140), pp.594-599
10/01/2020
DOI: 10.1136/postgradmedj-2019-137031
PMID: 31907225
Abstract
Objective
CT pulmonary angiography (CTPA) is one of the most commonly ordered CT imaging tests. It is often believed to be overutilised with few recent studies showing a yield of less than 2%. This study aimed to determine the overall positivity rate of CTPA examinations and understand the factors that affect the yield of the CTPA examination.
Methods
We retrospectively analysed 2713 patients who received the CTPA exam between 2016 and 2018. Type of study ordered (CTPA chest or CTPA chest with abdomen and pelvis CT), patient location (emergency department (ED), outpatient, inpatient, intensive care unit (ICU)) and patient characteristics-age, sex and body mass index (BMI) were recorded. A logistic regression analysis was performed to determine what factors affect the positivity rate of CT scans for pulmonary embolism (PE).
Results
With 296 positive test results, the overall CTPA positivity was 10.9%. Male sex was associated with higher CTPA positivity, gender difference was maximum in 18-year to 35-year age group. Overweight and obese patients had significantly higher positivity as compared with BMI<25 (p<0.05). Higher positivity rate was seen in the BMI 25-40 group (11.9%) as compared with BMI>40 (10.1%) (p<0.05). Significant difference (p<0.001) was also found in CTPA examination yield from ICU (15.3%) versus inpatients (other than ICU) (12.4%) versus ED (9.6%), and outpatients (8.5%). The difference in CTPA yield based on the type of CT order (CTPA chest vs CTPA chest with CT abdomen and pelvis), patient's age and sex was not significant.
Conclusion
CTPA yield of 10.9% in this study is comparable to acceptable positivity rate for the USA and is higher than recent studies showing positivity of <2%. Patient characteristics like obesity and ICU or inpatient location are associated with higher rate of CT positivity.
Details
- Title: Subtitle
- Pulmonary embolism rule out: positivity and factors affecting the yield of CT angiography
- Creators
- Tanya Aggarwal - University of IowaAli Eskandari - University of IowaSarv Priya - University of Iowa Hospitals and ClinicsAidan Mullan - University of California, BerkeleyIshan Garg - Mayo Clinic Rochester, Rochester, Minnesota, USA,Jakub Siembida - University of Iowa Hospitals and ClinicsBrian Mullan - University of Iowa Hospitals and ClinicsPrashant Nagpal - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Postgraduate medical journal, Vol.96(1140), pp.594-599
- Publisher
- Bmj Publishing Group
- DOI
- 10.1136/postgradmedj-2019-137031
- PMID
- 31907225
- ISSN
- 0032-5473
- eISSN
- 1469-0756
- Number of pages
- 6
- Language
- English
- Date published
- 10/01/2020
- Academic Unit
- Radiology
- Record Identifier
- 9984318817802771
Metrics
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