Concerning CT Findings Increase Health Care Utilization With Low-Risk Pulmonary Embolism

In HealthDay News
by Healthday

However, no short-term adverse clinical outcomes seen for these patients versus low-risk patients without concerning findings

By Lori Solomon HealthDay Reporter

TUESDAY, July 18, 2023 (HealthDay News) — Concerning computed tomography (CT) findings among patients with low-risk pulmonary embolism (PE) are associated with increased hospitalization and resource utilization without short-term adverse clinical outcomes, according to a study recently published in JAMA Network Open.

Connor O’Hare, M.D., from the University of Michigan in Ann Arbor, and colleagues examined whether concerning CT findings among patients seen in the emergency department with acute, low-risk PE are associated with differences in treatment and/or clinical outcome. The analysis included 817 adults with PE characterized as high risk or low risk (bilateral central embolus, right ventricle-to-left ventricle ratio greater than 1.0, right ventricle enlargement, septal abnormality, or pulmonary infarction).

The researchers found that 40.5 percent of PEs were low risk and 59.5 percent were high risk by PE Severity Index score. For all low-risk patients, clinical outcomes were similar, with no 30-day deaths in the low-risk group with concerning CTPE findings (0 of 151 patients) versus four of 180 (2.2 percent) in the low-risk group without concerning CT findings and 18.1 percent in the high-risk group. Compared with those without concerning CTPE findings, low-risk patients with concerning CT findings were less frequently discharged from the emergency department (2.0 versus 7.8 percent). Additionally, low-risk patients with concerning findings had more frequent echocardiography (57.6 versus 27.2 percent without concerning findings) and PE response team activation for consideration of advanced therapies (22.5 versus 6.1 percent).

“These findings suggest that concerning computed tomography imaging findings may be a significant barrier to outpatient treatment among patients with otherwise low-risk acute PE,” the authors write.

One author disclosed ties to the pharmaceutical industry.

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