The American Journal of Medicine
Volume 121, Issue 7 , Pages 611-617 , July 2008

Pulmonary Embolism Incidence Is Increasing with Use of Spiral Computed Tomography

  • Nicholas A. DeMonaco, MD

      Affiliations

    • Division of Hematology/Oncology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa
    • ,
  • Qianyu Dang, PhD

      Affiliations

    • Center for Healthcare Research, University of Pittsburgh, Pittsburgh, Pa
    • ,
  • Wishwa N. Kapoor, MD, MPH

      Affiliations

    • Center for Healthcare Research, University of Pittsburgh, Pittsburgh, Pa
    • Department of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pa
    • ,
  • Margaret V. Ragni, MD, MPH

      Affiliations

    • Division of Hematology/Oncology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa
    • Hemophilia Center of Western Pennsylvania, Pittsburgh, Pa.
    • Corresponding Author InformationRequests for reprints should be addressed to Margaret V. Ragni, MD, MPH, Professor of Medicine, Department of Medicine, Division Hematology/Oncology, University of Pittsburgh School of Medicine, Hemophilia Center of Western Pennsylvania, 3636 Boulevard of the Allies, Pittsburgh, PA 15213-4306.

References 

  1. Lindblad B, Eriksson A, Bergqvist D. Autopsy-verified pulmonary embolism in a surgical department: analysis of the period from 1951 to 1988. Br J Surg. 1991;78:849–852
  2. Anderson FA, Wheeler HB, Goldberg RJ, et al. A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism (The Worcester DVT Study). Arch Intern Med. 1991;151:933–938
  3. Holbert JM, Costello P, Federle MP. Role of spiral computed tomography in the diagnosis of pulmonary embolism in the emergency department. Ann Emerg Med. 1999;33:520–528
  4. British Thoracic Society Standards of Care Committee Pulmonary Embolism Guideline Development Group. British Thoracic Society guidelines for the management of suspected acute pulmonary embolism. Thorax. 2003;58:470–483
  5. Wells PS, Anderson DR, Rodger M, et al. Excluding pulmonary embolism at the bedside without diagnostic imaging: management of patients with suspected pulmonary embolism presenting to the emergency department by using a simple clinical model and d-dimer. Ann Intern Med. 2001;135:98–107
  6. Lee AY, Levine MN, Baker RI, et al. Randomized comparison of low-molecular-weight heparin versus oral anticoagulation for the prevention of thromboembolism in patients with cancer. N Engl J Med. 2003;349:146–153
  7. About the council. http://www.phc4.0rg/council/mission.htmAccessed August 1, 2005
  8. Pennsylvania Health Care Cost Containment Council, County Profiles, Hospital Discharge Data. Available at: http:www.phc4.0rg/countyprofiles/CountProfileResults.aspx; http:www.phc4.0rg/reports/fin1998report_volumeone.pdf. Accessed November 9, 2007.
  9. Rello J, Ollendorf DA, Oster G, et al. Epidemiology and outcomes of ventilator-associated pneumonia in a large US database. Chest. 2002;122:2115–2121
  10. International Classification of Diseases, Ninth Revision, Clinical Modification. Chicago: American Medical Association Press; 2004;
  11. National and state population estimates. http://www.census.gov/popest/estimates.phpAccessed February 8, 2005
  12. Silverstein MD, Heit JA, Mohr DN, et al. Trends in the incidence of deep venous thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med. 1998;158:585–593
  13. Ost D, Khanna D, Shah R, et al. Impact of spiral computed tomography on the diagnosis of pulmonary embolism in a community hospital setting. Respiration. 2004;71:444–447
  14. Stein PD, Hull RD, Kayali F, et al. Venous thromboembolism according to age. Arch Intern Med. 2004;164:2260–2265
  15. White RH, Zhou H, Romano PS. Incidence of idiopathic deep venous thrombosis and secondary thromboembolism among ethnic groups in California. Ann Intern Med. 1998;128:737–740
  16. Aujesky D, Obrosky DS, Stone RA, et al. A prediction rule to identify low-risk patients with pulmonary embolism. Arch Int Med. 2006;166:169–175
  17. Almahameed A, Carman TL. Outpatient management of stable acute pulmonary embolism: proposed accelerated pathway for risk stratification. Am J Med. 2007;120(10 Suppl 2):S18–S25
  18. Kovacs MJ, Anderson D, Morrow B, et al. Outpatient treatment of pulmonary embolism with dalteparin. Thromb Haemost. 2000;83:209–211
  19. Ramzi DW, Leeper KV. DVT and pulmonary embolism: part II. Treatment and prevention. Am Fam Physician. 2004;59:2841–2848
  20. Jimenez D, Yusen RD, Otero R, et al. Prognostic models for selecting patients with acute pulmonary embolism for initial outpatient therapy. Chest. 2007;132:7–8
  21. Prologo JD, Gilkeson RC, Diaz M, Asaad J. CT pulmonary angiography: a comparative analysis of the utilization patterns in emergency department and hospitalized patients between 1998 and 2003. Am J Roentgenol. 2004;183:1093–1106
  22. Kim KKI, Muller NL, Mayo JR. Clinically suspected pulmonary embolism: utility of spiral CT. Radiology. 1999;210:693–697
  23. Stein PD, Fowler SE, Goodman LR, et al. Multidetector computed tomograph for acute pulmonary embolism. N Engl J Med. 2006;354:2317–2327
  24. Le Gal G, Righini M, Parent F, et al. Diagnosis and management of subsegmental pulmonary embolism. J Thromb Haemost. 2006;4:724–731

 This work was sponsored by a grant from the Jewish Healthcare Foundation, Pittsburgh, Pennsylvania. The sponsor had no role in the design or conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the article.

PII: S0002-9343(08)00262-3

doi: 10.1016/j.amjmed.2008.02.035

The American Journal of Medicine
Volume 121, Issue 7 , Pages 611-617 , July 2008

Article Tools

* Image Usage & Resolution