Short summary

Pulmonary embolisms are among the most common causes of death due to vascular disease. To confirm or dismiss the diagnosis, computed tomography is utilized, exposing the patient to radiation. This study investigates if ultrasound may reduce the need for radiation diagnostics.

Rationale

Pulmonary embolism is a common condition and is the third most frequent cause of death due to vascular disease, only surpassed på hert attack and stroke. When the diagnosis is suspected, computed tomography or ventilations perfusion scan is utilized to finally confirm or dismiss the suspicion. While the diagnostic modalities are considered the diagnostic gold standards, they expose the patient to radiation, are expensive and require involvent of several staff members. This study investigates if integration of cardiac, lung and deep venous ultrasound may reduce the need for radiation diagnostics.

Description of the cohort

150 hemodynamically stable adult emergency department patients with suspected pulmonary embolism, requiring computed tomography or ventilation perfusion scintigraphy, will be enrolled and randomized 1:1 to either continuing to a scan as usual or receiving a multiorgan ultrasound investigation. Enrollment will be place at Odense University Hospital, Svendborg Hospital, Kolding Hospital and Slagelse Hospital.

Data and biological material

The following end-points will be registered: Primary endpoint: - Proportion of patients referred to CTPA or lung scintigraphy after multiorgan PoCUS. Secondary endpoints: - Adverse events, including readmission, serious bleeding or death within 6 months - Time until initiation of treatment from clinical evaluation - Proportion of patients diagnosed with PE - Proportion of patients diagnosed with alternative diagnosis following clinical evaluation - Proportion of patients discharged to their own home - Proportion of patients admitted to a cardiology department for telemetry monitoring (i.e. high risk PE) - Proportion of patients admitted to an intensive care unit - Proportion of patients referred to supplementary CTPA or lung scintigraphy within 30 days after inclusion - Total costs related to diagnostic work up and hospital stay - Subsequent cancer diagnosis within 6 months

Collaborating researchers and departments

Department of Respiratory Medicine, Odense University Hospital

• Prof, Senior consultant, Christian B Laursen

Department of Cardiology, Odense University Hospital

• Prof, Senior consultant, Jacob Eifer Møller
• Senior consultant, PhD, Mikael Kjær Poulsen

Department of Emergency Medicine, Odense University Hospital

• Prof, Senior consultant, Mikkel Brabrand
• Senior consultant, PhD, Stefan Posth

Department of Internal Medicine and Emegency Medicine, Svendborg Hospital

Department of Department of Internal Medicine and Emegency Medicine, Vejle Hospital

Department of Emergency Medicine, Slagelse Hospital