Short summary

Local retrospective survey of incidence and clinical characteristics of patients at the Hospital of Southwest Jutland Esbjerg referred for either CT angiography or V/Q scintigraphy with suspected acute pulmonary embolism.

Rationale

Acute pulmonary embolism (PE) is a common, ubiquitous, and potentially life-threatening disease. Highly effective treatment is available but associated with dangerous side effects. Patient history, symptoms, findings, and basic laboratory tests are notoriously non-specific, and diagnostic imaging is essential to avoid under-treatment and over-treatment. The primary contemporary modalities are radioisotope-based lung scintigraphy (V/Q scan) and computer tomography angiography (CTA), both with a place in different clinical settings but also with different pros and cons - and controversies remain regarding first-line imaging.

In the past 10-15 years the number of positive diagnoses has risen, maybe because the scans have improved, maybe because referring physicians suspect the diagnosis more often, but this is not well-known. At the same time, the number of scans is increasing which may be part of the explanation, but the incidence is usually reported to be 20-30%. On the other hand the number of positive diagnoses probably only comprise the tip of the iceberg; older autopsy studies suggest that only about 10% of patients are diagnosed ante mortem. Thus, there is room for significant improvement if we can better select patients for advanced imaging.  

This project aims to elucidate a more precise characterization of the very heterogeneous group of patients suspected of PE. By characterizing them more precisely we may be able to establish a better algorithm for referral to ensure a more rational use of the imaging modalities. Furthermore, a precise local incidence is necessary to perform power calculations for an upcoming prospeoctive comparison between CTA and V/Q scan.

Description of the cohort

All patients with suspected acute pulmonary embolism who underwent CT angiography or V/Q scintigraphy

Data and biological material

Clinical data from electronic patient charts, i.e. clinical characteristics (symptoms and objective findings), vital signs, results from other procedures and tests (blood samples, pathology reports, imaging reports), Well's score or data necessary to calculate this, treatment regimen.