Is CT pulmonary angiography overutilized in the evaluation of patients with suspected pulmonary embolism? A retrospective study

• DOI: 10.29390/001c.127660
• Publication Date: 2025-01-13T20:23:23Z
• Authors: Rabbani Mahmoud D...; Ahmed Majeed Mohamed; Muath Salahuddin ...; Salim Fredericks; Israa ElSayed Daoud; Moath Mahmoud Daoud; Mahmood AlSaeed
• Keywords: Nice; Pulmonary angiography; Demographics; Computed Tomography Angiography

Introduction Despite the high mortality rate of acute untreated pulmonary embolism (PE) at 30%, diagnosing PE is challenging. While prevalence has decreased in recent years, overuse computed tomography angiography (CTPA) remains a concern. The National Institute for Health and Care Excellence (NICE) provides guidelines using Wells score assessment. Royal College Radiologists (RCR) recommends positive yield 15.4% - 37% CTPA tests. This study assesses suspected patients evaluates potential reduction through score/D-dimer assessment as recommended by NICE. Methods All who underwent between September 1, 2019, January 31, 2020, Salmaniya Medical Complex were included. Data on patient demographics pre-CTPA workup collected from electronic records (EPR) stored MS Excel 2019 analysis. Results Of 188 (mean age 50 ±12.3 years; 62.8% female), 12.2% diagnosed with PE. None had documented scores. A low-risk (≤4) was assigned to 68.6% patients, only 26.1% undergoing D-dimer testing. confirmed 4 scores elevated D-dimers. 10 negative D-dimers PE-negative. Conclusion In total, 5.3% 47.9% CTPAs conducted could have been avoided following NICE guidelines. We propose integrating an algorithm-based checklist validated tools like Geneva into ePMA system guide appropriate referrals, promote evidence-based decision-making, reduce unnecessary imaging, optimize care resource use.