Type:
Educational Exhibit
Keywords:
Emergency, Lung, CT, Cost-effectiveness, Outcomes, Quality assurance
DOI:
10.26044/ranzcr2023/C-65
Imaging findings OR Procedure details
97 CTPA's were assessed. The positive rate of CTPA was 8%, below the recommended 15%. No requests had used the specific CTPA request form.
46% of performed CTPA's should have had further work up before imaging was considered. Only 19 patients (19%) had a Wells' score documented (Table 1). 7 patients had a Wells' under 2 and, of these, 2 patients did not have a PERC documented (Table 2). All of these 7 patients received an inappropriately ordered D-dimer, all of which were positive. All 7 had a negative CTPA.
39 CTPA’s (40%) did not have a D-dimer taken. Only 2 of these patients had a Wells' score recorded over 6. Meaning 38% should have had a D-dimer before considering a CTPA.
Of the 58 people who did get a D-dimer, 4 had a negative age adjusted D-dimer and inappropriately went on to get a CTPA, all of which were negative.