• Am J Med Qual · Jan 2012

    Inappropriate use of D-dimer assay and pulmonary CT angiography in the evaluation of suspected acute pulmonary embolism.

    • Fang Yin, Thomas Wilson, Albert Della Fave, Moira Larsen, Jenni Yoon, Binyam Nugusie, Howard Freeland, and Robert Dobbin Chow.
    • Good Samaritan Hospital of Maryland, Baltimore, USA. fang.yin@nih.gov
    • Am J Med Qual. 2012 Jan 1;27(1):74-9.

    AbstractThe authors question whether the d-dimer assay and pulmonary computed tomography angiography (CTA) are being used appropriately to evaluate suspected acute pulmonary embolism (PE) at their hospital. To answer this question, a retrospective review was performed on all emergency department (ED) patients who underwent d-dimer assay and/or CTA from August 15, 2008, to August 14, 2009. The authors' algorithm for diagnosing PE requires that patients with low or intermediate probability of acute PE undergo a d-dimer assay, followed by CTA if the d-dimer is positive. Patients with high probability of PE should have CTA performed without a d-dimer assay. This result suggests that d-dimer assay and CTA are used inappropriately to evaluate patients with suspected acute PE in our ED. The low threshold for initiating an evaluation for PE decreases the prevalence of PE in this population.

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