2009PubMedRequires access

[Therapeutic consequences of lung scintigraphy in patients with intermediate probability of pulmonary embolism].

Ea Sofie Marmolin, Louise Møller, Allan Johansen, Poul Henning Madsen, Søren Hess

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Abstract

INTRODUCTION: Pulmonary embolism has a high mortality and is difficult to diagnose. Lung scintigraphy is widely used. However, a significant number of patients receive an inconclusive result. The aim of this study was to determine how patients with an intermediate result were handled. MATERIAL AND METHODS: Case notes from 321 (77%) of a total of 416 consecutive patients who underwent lung scintigraphy at Odense University Hospital in 2004 were examined retrospectively. RESULTS: We found 98 (30%) patients with an intermediate probability of pulmonary embolism, among whom 14 (14%) underwent further investigation, 28 (29%) received treatment, and in 29 (30%) cases, the result was interpreted as negative for pulmonary embolism. We found no significant difference in demographic data or results of investigations performed before the scintigraphy between those who received treatment and those who did not, nor was there any difference between those who were interpreted as negative and those who were not. CONCLUSION: Few patients with intermediate probability underwent further investigation and one third was interpreted as negative for pulmonary embolism, contrary to the recommendations of several guidelines. In patients with intermediate probability of pulmonary embolism we demonstrated no differences in patient history or clinical presentation between those who received treatment and those who did not.

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INTRODUCTION: Pulmonary embolism has a high mortality and is difficult to diagnose. Lung scintigraphy is widely used. However, a significant number of patients receive an inconclusive result. The aim of this study was to determine how patients with an intermediate result were handled. MATERIAL AND METHODS: Case notes from 321 (77%) of a total of 416 consecutive patients who underwent lung scintigraphy at Odense University Hospital in 2004 were examined retrospectively. RESULTS: We found 98 (30%) patients with an intermediate probability of pulmonary embolism, among whom 14 (14%) underwent further investigation, 28 (29%) received treatment, and in 29 (30%) cases, the result was interpreted as negative for pulmonary embolism. We found no significant difference in demographic data or results of investigations performed before the scintigraphy between those who received treatment and those who did not, nor was there any difference between those who were interpreted as negative and those who were not. CONCLUSION: Few patients with intermediate probability underwent further investigation and one third was interpreted as negative for pulmonary embolism, contrary to the recommendations of several guidelines. In patients with intermediate probability of pulmonary embolism we demonstrated no differences in patient history or clinical presentation between those who received treatment and those who did not.

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Available abstract

INTRODUCTION: Pulmonary embolism has a high mortality and is difficult to diagnose. Lung scintigraphy is widely used. However, a significant number of patients receive an inconclusive result. The aim of this study was to determine how patients with an intermediate result were handled. MATERIAL AND METHODS: Case notes from 321 (77%) of a total of 416 consecutive patients who underwent lung scintigraphy at Odense University Hospital in 2004 were examined retrospectively. RESULTS: We found 98 (30%) patients with an intermediate probability of pulmonary embolism, among whom 14 (14%) underwent further investigation, 28 (29%) received treatment, and in 29 (30%) cases, the result was interpreted as negative for pulmonary embolism. We found no significant difference in demographic data or results of investigations performed before the scintigraphy between those who received treatment and those who did not, nor was there any difference between those who were interpreted as negative and those who were not. CONCLUSION: Few patients with intermediate probability underwent further investigation and one third was interpreted as negative for pulmonary embolism, contrary to the recommendations of several guidelines. In patients with intermediate probability of pulmonary embolism we demonstrated no differences in patient history or clinical presentation between those who received treatment and those who did not.

Key concepts: Pulmonary embolism, Medicine, Scintigraphy, Lung, Significant difference, Radiology, Surgery, Internal medicine

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