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Addendum to Optimal Strategies for the Diagnosis of Acute PulmonaryEmbolism: A Health Technology Assessment – Project Protocol Addendum to Optimal Strategies for the Diagnosis of Acute PulmonaryEmbolism: A Health Technology Assessment – Project Protocol | CADTH.ca CADTH Document Viewer Addendum to Optimal Strategies for the Diagnosis of Acute PulmonaryEmbolism: A Health Technology Assessment – Project Protocol Table of Contents Search this document Addendum to Optimal Strategies (...) for the Diagnosis of Acute PulmonaryEmbolism: A Health Technology Assessment – Project Protocol October 2016 Ethics Review This protocol was written a priori and will be followed throughout the review process. There are two broad normative questions to consider regarding diagnosis of acute pulmonaryembolism (PE): Should we provide diagnosis of acute PE? If yes, which strategies should be provided, and how best should those strategies be provided to diagnose those with acute PE? Both of these questions
Prevalence of PulmonaryEmbolism among Patients Hospitalized for Syncope. The prevalence of pulmonaryembolism among patients hospitalized for syncope is not well documented, and current guidelines pay little attention to a diagnostic workup for pulmonaryembolism in these patients.We performed a systematic workup for pulmonaryembolism in patients admitted to 11 hospitals in Italy for a first episode of syncope, regardless of whether there were alternative explanations for the syncope (...) . The diagnosis of pulmonaryembolism was ruled out in patients who had a low pretest clinical probability, which was defined according to the Wells score, in combination with a negative d-dimer assay. In all other patients, computed tomographic pulmonary angiography or ventilation-perfusion lung scanning was performed.A total of 560 patients (mean age, 76 years) were included in the study. A diagnosis of pulmonaryembolism was ruled out in 330 of the 560 patients (58.9%) on the basis of the combination
Treatment of acute pulmonaryembolism with dabigatran versus warfarin. A pooled analysis of data from RE-COVER and RE-COVER II Dabigatran was non-inferior to warfarin for prevention of recurrent venous thromboembolism (VTE), and dabigatran had a lower rate of bleeding compared with warfarin in two large-scale randomised trials, RE-COVER and RE-COVER II. In this study, we investigate the efficacy and safety of dabigatran versus warfarin according to the index event that qualified the patient (...) for enrollment, either symptomatic pulmonaryembolism (PE) with or without deep-vein thrombosis (DVT), or DVT alone. We then analyse the anticoagulant effect of dabigatran vs warfarin on patients enrolled with PE. The pooled dataset for the efficacy analysis consisted of 2553 and 2554 patients who were randomised to dabigatran and warfarin, respectively. Recurrent VTE/VTE-related death during the study period and additional 30-day follow-up occurred in 2.7 % of all patients on dabigatran and in 2.4
Percutaneous mechanical thrombectomy for pulmonaryembolism Percutaneous mechanical thrombectomy for pulmonaryembolism Percutaneous mechanical thrombectomy for pulmonaryembolism HAYES, Inc. Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc.. Percutaneous mechanical thrombectomy for pulmonaryembolism. Lansdale: HAYES, Inc.. Directory Publication. 2016 (...) alone has failed or is contraindicated. However, the technology is invasive and relatively new, warranting assessment of effectiveness, safety, and the performance of the different commercially available devices. Relevant Questions: For patients with pulmonaryembolism (PE), is PMT effective for eliminating thromboses and emboli, restoring blood flow and vascular function, and preventing damage to tissues and organs? Are PMT devices safe? How do PMT devices compare with other standard treatments
Diagnostic characteristics of lower limb venous compression ultrasonography in suspected pulmonaryembolism: a meta-analysis Essentials Lower limb ultrasonography (CUS) could be useful in suspected pulmonaryembolism (PE). We performed a metaanalysis on the diagnostic characteristics of CUS in suspected PE. With a sensitivity of 41%, proximal CUS would be positive in one of every 7.3 patients. Complete CUS has a higher sensitivity but specificity for PE is too low to use it in suspected (...) PE.Background Diagnosis of pulmonaryembolism (PE) is commonly based on D-dimer measurement and computed tomography (CT) angiography. Lower limb vein compression ultrasonography (CUS) for diagnosing deep vein thrombosis may be of interest in patients with suspected PE. Objectives We aimed to summarize the data on the diagnostic characteristics of CUS in suspected PE patients. Patients/Methods We conducted a literature review by using PUBMED and EMBASE and included 15 prospective studies in which CUS
D-dimer test for excluding the diagnosis of pulmonaryembolism. Pulmonaryembolism (PE) can occur when a thrombus (blood clot) travels through the veins and lodges in the arteries of the lungs, producing an obstruction. People who are thought to be at risk include those with cancer, people who have had a recent surgical procedure or have experienced long periods of immobilisation and women who are pregnant. The clinical presentation can vary, but unexplained respiratory symptoms (...) recruitment.We searched 13 databases from conception until December 2013. We cross-checked the reference lists of relevant studies.Two review authors independently applied exclusion criteria to full papers and resolved disagreements by discussion.We included cross-sectional studies of D-dimer in which ventilation/perfusion (V/Q) scintigraphy, computerised tomography pulmonary angiography (CTPA), selective pulmonary angiography and magnetic resonance pulmonary angiography (MRPA) were used as the reference
Optimal Imaging for Suspected Acute PulmonaryEmbolism Optimal Strategies for the Diagnosis of Acute PulmonaryEmbolism | CADTH.ca Find the information you need Optimal Strategies for the Diagnosis of Acute PulmonaryEmbolism Optimal Strategies for the Diagnosis of Acute PulmonaryEmbolism Published on: March 1, 2018 Project Number: OP0528-000 Product Line: Research Type: Other Diagnostics Result type: Report Pulmonaryembolism (PE) is a blockage of one of the arteries in the lung, frequently (...) as potential environmental impact were also addressed. Tags blood, decision support techniques, diagnostic tests, echocardiography, fibrin fibrinogen degradation products, magnetic resonance imaging, pet scan, perfusion imaging, positron-emission tomography, pulmonaryembolism, radionuclide imaging, spect, tomography, ultrasonography, venous thromboembolism, ct scan, imaging, mri, respiratory, ultrasound, CT angiography, CT pulmonary angiography, CTPA, Emission-Computed, Geneva, MRIs, PERC, PET, PET-CT
Optimal Diagnosis for Suspected Acute PulmonaryEmbolism Optimal Strategies for the Diagnosis of Acute PulmonaryEmbolism | CADTH.ca Find the information you need Optimal Strategies for the Diagnosis of Acute PulmonaryEmbolism Optimal Strategies for the Diagnosis of Acute PulmonaryEmbolism Published on: March 1, 2018 Project Number: OP0528-000 Product Line: Research Type: Other Diagnostics Result type: Report Pulmonaryembolism (PE) is a blockage of one of the arteries in the lung, frequently (...) as potential environmental impact were also addressed. Tags blood, decision support techniques, diagnostic tests, echocardiography, fibrin fibrinogen degradation products, magnetic resonance imaging, pet scan, perfusion imaging, positron-emission tomography, pulmonaryembolism, radionuclide imaging, spect, tomography, ultrasonography, venous thromboembolism, ct scan, imaging, mri, respiratory, ultrasound, CT angiography, CT pulmonary angiography, CTPA, Emission-Computed, Geneva, MRIs, PERC, PET, PET-CT
On the necessity of new decision-making methods for cancer-associated, symptomatic, pulmonaryembolism Acute symptomatic pulmonaryembolism (PE) varies in its clinical manifestations in patients with cancer and entails specific issues. The objective is to assess the performance of five scores (PESI, sPESI, GPS, POMPE, and RIETE) and a clinical decision rule to predict 30-day mortality.This is an ambispective, observational, multicenter study that collected episodes of PE in patients with cancer
Deep vein thrombosis and pulmonaryembolism. Deep vein thrombosis and pulmonaryembolism, collectively referred to as venous thromboembolism, constitute a major global burden of disease. The diagnostic work-up of suspected deep vein thrombosis or pulmonaryembolism includes the sequential application of a clinical decision rule and D-dimer testing. Imaging and anticoagulation can be safely withheld in patients who are unlikely to have venous thromboembolism and have a normal D-dimer. All other (...) patients should undergo ultrasonography in case of suspected deep vein thrombosis and CT in case of suspected pulmonaryembolism. Direct oral anticoagulants are first-line treatment options for venous thromboembolism because they are associated with a lower risk of bleeding than vitamin K antagonists and are easier to use. Use of thrombolysis should be limited to pulmonaryembolism associated with haemodynamic instability. Anticoagulant treatment should be continued for at least 3 months to prevent
Comparison of risk assessment strategies for not-high-risk pulmonaryembolism We compared the prognostic performance of the 2014 European Society of Cardiology (ESC) risk stratification algorithm with the previous 2008 ESC algorithm, the Bova score and the modified FAST score (based on a positive heart-type fatty acid-binding protein (H-FABP) test, syncope and tachycardia, modified using high-sensitivity troponin T instead of H-FABP) in 388 normotensive pulmonaryembolism patients included (...) in a single-centre cohort study.Overall, 25 patients (6.4%) had an adverse 30-day outcome. Regardless of the score or algorithm used, the rate of an adverse outcome was highest in the intermediate-high-risk classes, while all patients classified as low-risk had a favourable outcome (no pulmonaryembolism-related deaths, 0-1.4% adverse outcome). The area under the curve for predicting an adverse outcome was higher for the 2014 ESC algorithm (0.76, 95% CI 0.68-0.84) compared with the 2008 ESC algorithm
Wells Rule and d-Dimer Testing to Rule Out PulmonaryEmbolism: A Systematic Review and Individual-Patient Data Meta-analysis. The performance of different diagnostic strategies for pulmonaryembolism (PE) in patient subgroups is unclear.To evaluate and compare the efficiency and safety of the Wells rule with fixed or age-adjusted d-dimer testing overall and in inpatients and persons with cancer, chronic obstructive pulmonary disease, previous venous thromboembolism, delayed presentation
Low dose oestrogen combined oral contraception and risk of pulmonaryembolism, stroke, and myocardial infarction in five million French women: cohort study. To assess the risk of pulmonaryembolism, ischaemic stroke, and myocardial infarction associated with combined oral contraceptives according to dose of oestrogen (ethinylestradiol) and progestogen.Observational cohort study.Data from the French national health insurance database linked with data from the French national hospital discharge (...) database.4 945 088 women aged 15-49 years, living in France, with at least one reimbursement for oral contraceptives and no previous hospital admission for cancer, pulmonaryembolism, ischaemic stroke, or myocardial infarction, between July 2010 and September 2012.Relative and absolute risks of first pulmonaryembolism, ischaemic stroke, and myocardial infarction.The cohort generated 5 443 916 women years of oral contraceptive use, and 3253 events were observed: 1800 pulmonaryembolisms (33 per 100 000
Diagnostic accuracy of magnetic resonance angiography for acute pulmonaryembolism - a systematic review and meta-analysis. The aim of this meta-analysis was to evaluate the diagnostic accuracy of magnetic resonance angiography (MRA) for acute pulmonaryembolism (PE).A systematic literature search was conducted that included studies from January 2000 to August 2015 using the electronic databases PubMed, Embase and Springer link. The summary receiver operating characteristic (SROC) curve
Oral and inhaled corticosteroid use and risk of recurrent pulmonaryembolism Chronic inflammatory diseases predispose for development of a first pulmonaryembolism (PE). Previous studies showed that corticosteroids, which are the mainstay of treatment for inflammatory diseases, enhance the risk of a first venous thromboembolism. Yet, it is unknown whether corticosteroids also predispose for recurrent events. Therefore, we investigated the association between oral and/or inhaled corticosteroid
Investigation and treatment of pulmonaryembolism as a potential etiology may be important to improve postâ€resuscitation prognosis in nonâ€shockable outâ€ofâ€hospital cardiopulmonary arrest: report on an analysis of the SOSâ€KANTO 2012 study The prognosis of non-shockable out-of-hospital cardiac arrest is worse than that of shockable out-of-hospital cardiac arrest. We investigated the associations between the etiology and prognosis of non-shockable out-of-hospital cardiac arrest patients (...) and 3 months between various etiological and presumed cardiac factors. The proportion of the favorable brain function patients that developed pulmonaryembolism or incidental hypothermia was significantly higher than that of the patients with presumed cardiac factors (1 month, P < 0.0001 and P < 0.0001, respectively; 3 months, P = 0.0018 and P < 0.0001, respectively). In multiple logistic regression analysis, pulmonaryembolism and incidental hypothermia were found to be significant independent
Effectiveness of prognosticating pulmonaryembolism using the ESC algorithm and the Bova score The prognostic value of the European Society of Cardiology (ESC) 2014 algorithm and the Bova score has lacked adequate validation. According to the ESC 2014 guidelines and the Bova score, we retrospectively risk stratified normotensive patients with PE who were enrolled in the PROTECT study. This study used a complicated course (which consisted of death from any cause, haemodynamic collapse (...) , or recurrent PE) as the primary endpoint, and follow-up occurred through 30 days after the PE diagnosis. Of 848 patients, 37 % had a sPESI of 0 and 5 (1.6 %; 95 % confidence interval [CI], 0.5-3.7 %) experienced a complicated course. Of 143 patients with a sPESI of 0 points and negative computed tomographic pulmonary angiography (CTPA) for right ventricle (RV) dysfunction, three (2.1 %; 95 % CI, 0.4-6.0 %) experienced a complicated course. Four hundred seventy-eight (56 %) patients with a sPESI ≥ 1 had
Pulmonaryembolism in an adolescent girl with negative ACLA systemic lupus erythematosus (SLE): a case report Pulmonary involvement is a common manifestation in systemic lupus erythematosus (SLE), whereas pulmonary thromboembolism (PTE) is rarely seen in SLE. PTE related to anti-phospholipid antibody syndrome (APS) is also a rare disease. We have reported a 13-year-old female diagnosed with SLE Two years ago, who is being treated with hydroxychloroquine and prednisolone. She presented (...) with shortness of breath, dry cough, and fever about two weeks prior to admission. She was initially admitted with the diagnosis of pneumonia, but no clinical improvement was seen she was given antibiotics. Hemoptysis was added to her symptoms, so spiral high resolution computed tomography (HRCT) of the lungs was requested, and it indicated patchy consolidations bilaterally. With suspicion of pulmonary thromboembolism (PTE), spiral computed tomography angiography of pulmonary vessels was done, revealing PTE
Time trends and case fatality rate of in-hospital treated pulmonaryembolism during 11 years of observation in Northwestern Italy Pulmonaryembolism (PE) is a common disorder with high mortality and morbidity rates. However, population-based information on its incidence and prognosis remains limited. We conducted a large epidemiology study collecting data on hospitalisation for PE (from 2002 to 2012) in a population of about 13 million people in Northwestern Italy. Patients were identified
Anticoagulant treatment for subsegmental pulmonaryembolism. Acute pulmonaryembolism (PE) is a common cause of death, accounting for 50,000 to 200,000 deaths annually. It is the third most common cause of mortality among the cardiovascular diseases, after coronary artery disease and stroke.The advent of multi-detector computed tomographic pulmonary angiography (CTPA) has allowed better assessment of PE regarding visualisation of the peripheral pulmonary arteries, increasing its rate (...) PEs. However, the clinical significance in patients and their prognosis have to be studied to evaluate whether anticoagulation therapy is required.This review is an update of a Cochrane systematic review first published in 2014.To assess the effectiveness and safety of anticoagulation therapy versus no intervention in patients with isolated subsegmental pulmonaryembolism (SSPE) or incidental SSPE.The Cochrane Vascular Trials Search Co-ordinator searched the Specialised Register (last searched