Comprehensive Evaluation of the Diagnostic Approach to Pulmonary Embolism: Analysis of D-Dimer Utilization, Imaging Modalities (CTPA and V/Q Scan), and Clinical Risk Stratification Tools
DOI:
https://doi.org/10.70749/ijbr.v3i1.511Keywords:
Pulmonary Embolism, D-Dimer, CTPA, V/Q Scan, Clinical Risk StratificationAbstract
Background: Pulmonary embolism (PE) is a serious condition caused by blood clots blocking the pulmonary arteries, requiring early diagnosis for effective management. Diagnostic procedures include clinical evaluation based on patient risk, D-Dimer biomarker tests, CT pulmonary angiography (CTPA), and V/Q scans. However, adherence to these diagnostic guidelines is not always consistent. This audit aimed to assess the diagnostic procedures for suspected acute PE at Lady Reading Hospital (LRH), focusing on D-Dimer testing, imaging, and clinical probability assessments. Methodology: This retrospective audit analyzed records of 300 patients over one year who were suspected of having PE. Patient data, including demographic information, clinical symptoms, and diagnostic tests (D-Dimer, CTPA, and V/Q scans), were collected. Risk stratification was done using the Wells and Revised Geneva Scores. The audit examined adherence to diagnostic protocols and evaluated the time from patient presentation to diagnosis. Data were analyzed using descriptive statistics and Chi-square tests. Results and Discussion: The audit found that 80% of patients underwent D-Dimer testing, and 70% had imaging. CTPA was the primary imaging method for 70% of patients, with PE confirmed in 40%. Risk assessments showed 50% of patients were at intermediate risk. Diagnostic processes were generally efficient, although 10 cases had issues, and 3.3% of patients experienced adverse events. Key concerns identified included the need for better compliance with guidelines and improved diagnostic organization. Conclusion: This audit highlights the importance of adhering to clinical pathways and optimizing diagnostic procedures at LRH. Recommendations include stricter guideline compliance, simplifying diagnostic algorithms, and ensuring appropriate imaging use for PE diagnosis.
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