Pulmonary embolism diagnosis clinical decision rule
Conditions
Interventions
In case of a first PE, a CT scan is performed in the following combination of tests:
1. Decision rules disagree with each other (one (or more) indicating ‘unlikely’ probability, other(s) indicating
2. All four decision rules indicate a ‘likely' probability for PE
3. All four decision rules indicate an ‘unlikely’ probability for PE but D-dimer is abnormal.
In case of a recurrent pulmonary embolism, the Wells rule will prefer, a CT is performed in case of (figu
2. A combination of a low probability of the Wells score and an abnormal D-dimer.
Sponsors
LUMC
Eligibility
Inclusion criteria
Inclusion criteria: 1. Out- or inpatients with a first episode of clinically suspected pulmonary embolism; 2. Suspected recurrent pulmonary embolism for study question B.
Exclusion criteria
Exclusion criteria: 1. Age < 18 years; 2. Life expectancy < 3 months; 3. Treatment with full-dose therapeutic low molecular weight heparin or unfractionated heparin that was initiated 24 hours or more prior to eligibility assessment; 4. Treatment with vitamin K antagonists (coumarin derivates); 5. Contraindication to helical CT: A. Allergy to intravenous iodinated contrast; B. Renal insufficiency (creatinine clearance < 30 ml/min); C. Pregnancy; D. Impossibility to return for follow-up.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| (Recurrent) pulmonary embolism or deep vein thrombosis. | — |
Secondary
| Measure | Time frame |
|---|---|
| Performance of four clinical decision rules. | — |
Contacts
Public ContactM.V. Huisman
Leiden University Medical Center (LUMC) Department of Thrombosis and Haemostasis Room C4-68 P.O Box 9600
Outcome results
None listed