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Mirabile A, Lucarelli NM, Sollazzo EP, et al. CT pulmonary angiography appropriateness in a single emergency department: does the use of revised Geneva score matter?. Radiol Med. 2021;126(12):1544-1552doi: 10.1007/s11547-021-01416-x.
Mirabile, A., Lucarelli, N. M., Sollazzo, E. P., Stabile Ianora, A. A., Sardaro, A., Mirabile, G., Lorusso, F., Racanelli, V., Maggialetti, N., & Scardapane, A. (2021). CT pulmonary angiography appropriateness in a single emergency department: does the use of revised Geneva score matter?. La Radiologia medica, 126(12), 1544-1552. https://doi.org/10.1007/s11547-021-01416-x
Mirabile, Alessandra, et al. "CT pulmonary angiography appropriateness in a single emergency department: does the use of revised Geneva score matter?." La Radiologia medica vol. 126,12 (2021): 1544-1552. doi: https://doi.org/10.1007/s11547-021-01416-x
Mirabile A, Lucarelli NM, Sollazzo EP, Stabile Ianora AA, Sardaro A, Mirabile G, Lorusso F, Racanelli V, Maggialetti N, Scardapane A. CT pulmonary angiography appropriateness in a single emergency department: does the use of revised Geneva score matter?. Radiol Med. 2021 Dec;126(12):1544-1552. doi: 10.1007/s11547-021-01416-x. Epub 2021 Sep 13. PMID: 34518985; PMCID: PMC8702417.
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Radiol Med. 2021 Dec;126(12):1544-1552. doi: 10.1007/s11547-021-01416-x. Epub 2021 Sep 13.

CT pulmonary angiography appropriateness in a single emergency department: does the use of revised Geneva score matter?.

La Radiologia medica

Alessandra Mirabile, Nicola Maria Lucarelli, Enza Pia Sollazzo, Amato Antonio Stabile Ianora, Angela Sardaro, Gianmario Mirabile, Filomenamila Lorusso, Vito Racanelli, Nicola Maggialetti, Arnaldo Scardapane

Affiliations

  1. Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, University of Bari Medical School "Aldo Moro", Piazza Giulio Cesare 11, 70124, Bari, Italy. [email protected].
  2. Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, University of Bari Medical School "Aldo Moro", Piazza Giulio Cesare 11, 70124, Bari, Italy.
  3. Department of Biomedical Sciences and Human Oncology, University of Bari Medical School "Aldo Moro", Piazza Giulio Cesare 11, 70124, Bari, Italy.
  4. Department of Electrical and Information Engineering, Polytechnic University of Bari, 70125, Bari, Italy.
  5. Department of Basic Medical Sciences, Neuroscience and Sense Organs, (DSMBNOS), University of Bari Medical School "Aldo Moro", Piazza Giulio Cesare 11, 70124, Bari, Italy.

PMID: 34518985 PMCID: PMC8702417 DOI: 10.1007/s11547-021-01416-x

Abstract

PURPOSE: To assess the percentage of computed tomography pulmonary angiography (CTPA) procedures that could have been avoided by methodical application of the Revised Geneva Score (RGS) coupled with age-adjusted D-dimer cut-offs rather than only clinical judgment in Emergency Department patients with suspected pulmonary embolism (PE).

MATERIAL AND METHODS: Between November 2019 and May 2020, 437 patients with suspected PE based on symptoms and D-dimer test were included in this study. All patients underwent to CTPA. For each patient, we retrospectively calculated the age-adjusted D-dimer cut-offs and the RGS in the original version. Finally, CT images were retrospectively reviewed, and the presence of PE was recorded.

RESULTS: In total, 43 (9.84%) CTPA could have been avoided by use of RGS coupled with age-adjusted D-dimer cut-offs. Prevalence of PE was 14.87%. From the analysis of 43 inappropriate CTPA, 24 (55.81%) of patients did not show any thoracic signs, two (4.65%) of patients had PE, and the remaining patients had alternative thoracic findings.

CONCLUSION: The study showed good prevalence of PE diagnoses in our department using only physician assessment, although 9.84% CTPA could have been avoided by methodical application of RGS coupled with age-adjusted D-dimer cut-offs.

© 2021. The Author(s).

Keywords: Age-adjusted D-dimer cut-offs; Computed tomography pulmonary angiography; Pulmonary embolism; Revised Geneva score

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