The clinical features of acute pulmonary embolism in ambulatory patients

Otto Susec, Dawn Boudrow, Jeffrey Kline

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Objective: To identify clinical findings and predisposing conditions associated with acute pulmonary embolism (PE) in ambulatory patients being evaluated for PE. Methods: A prospective observational study was conducted. A standardized multicomponent data collection form was administered to ambulatory subjects being evaluated for PE. The diagnosis of PE was confirmed or excluded using a combination of scintillation lung scanning, lower- extremity venous Doppler ultrasonography, and selective use of pulmonary angiography. Results: Data collection was completed for 170 subjects, with 26 (15%) cases of PE. SubJects with PE were significantly older (56 vs 41 years. 99% CI for difference of 15 years [6 to 25 years]), were more likely to report unexplained dyspnea (92% vs 69% 99% CI for difference of 23% [7% to 40%]), and waited longer after symptom onset to seek medical evaluation (73 vs 36 hours. 99% CI for difference of 37 hours [11 to 63 hours]). No difference was found for multiple variables commonly associated with PE. Assignment to risk categories was of limited diagnostic utility. For example, low-risk assignment yielded 85% sensitivity, 20% specificity; high-risk assignment: 31% sensitivity, 85% specificity, with diagnostic accuracy below 80% in both categories. Conclusions: Among outpatients selected for evaluation for PE, further risk stratification demonstrated poor diagnostic utility. Clinical features alone cannot be used to differentiate presence or absence of PE in at-risk ambulatory patients.

Original languageEnglish (US)
Pages (from-to)891-897
Number of pages7
JournalAcademic Emergency Medicine
Volume4
Issue number9
StatePublished - Sep 1997
Externally publishedYes

Fingerprint

Pulmonary Embolism
Sensitivity and Specificity
Doppler Ultrasonography
Lung
Dyspnea
Observational Studies
Lower Extremity
Angiography
Outpatients
Prospective Studies

Keywords

  • Clinical features
  • Diagnosis
  • Outpatient
  • Pulmonary embolism
  • Risk

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

The clinical features of acute pulmonary embolism in ambulatory patients. / Susec, Otto; Boudrow, Dawn; Kline, Jeffrey.

In: Academic Emergency Medicine, Vol. 4, No. 9, 09.1997, p. 891-897.

Research output: Contribution to journalArticle

@article{d444d2a2e2fe4fe98ddeaa926721bc15,
title = "The clinical features of acute pulmonary embolism in ambulatory patients",
abstract = "Objective: To identify clinical findings and predisposing conditions associated with acute pulmonary embolism (PE) in ambulatory patients being evaluated for PE. Methods: A prospective observational study was conducted. A standardized multicomponent data collection form was administered to ambulatory subjects being evaluated for PE. The diagnosis of PE was confirmed or excluded using a combination of scintillation lung scanning, lower- extremity venous Doppler ultrasonography, and selective use of pulmonary angiography. Results: Data collection was completed for 170 subjects, with 26 (15{\%}) cases of PE. SubJects with PE were significantly older (56 vs 41 years. 99{\%} CI for difference of 15 years [6 to 25 years]), were more likely to report unexplained dyspnea (92{\%} vs 69{\%} 99{\%} CI for difference of 23{\%} [7{\%} to 40{\%}]), and waited longer after symptom onset to seek medical evaluation (73 vs 36 hours. 99{\%} CI for difference of 37 hours [11 to 63 hours]). No difference was found for multiple variables commonly associated with PE. Assignment to risk categories was of limited diagnostic utility. For example, low-risk assignment yielded 85{\%} sensitivity, 20{\%} specificity; high-risk assignment: 31{\%} sensitivity, 85{\%} specificity, with diagnostic accuracy below 80{\%} in both categories. Conclusions: Among outpatients selected for evaluation for PE, further risk stratification demonstrated poor diagnostic utility. Clinical features alone cannot be used to differentiate presence or absence of PE in at-risk ambulatory patients.",
keywords = "Clinical features, Diagnosis, Outpatient, Pulmonary embolism, Risk",
author = "Otto Susec and Dawn Boudrow and Jeffrey Kline",
year = "1997",
month = "9",
language = "English (US)",
volume = "4",
pages = "891--897",
journal = "Academic Emergency Medicine",
issn = "1069-6563",
publisher = "Wiley-Blackwell",
number = "9",

}

TY - JOUR

T1 - The clinical features of acute pulmonary embolism in ambulatory patients

AU - Susec, Otto

AU - Boudrow, Dawn

AU - Kline, Jeffrey

PY - 1997/9

Y1 - 1997/9

N2 - Objective: To identify clinical findings and predisposing conditions associated with acute pulmonary embolism (PE) in ambulatory patients being evaluated for PE. Methods: A prospective observational study was conducted. A standardized multicomponent data collection form was administered to ambulatory subjects being evaluated for PE. The diagnosis of PE was confirmed or excluded using a combination of scintillation lung scanning, lower- extremity venous Doppler ultrasonography, and selective use of pulmonary angiography. Results: Data collection was completed for 170 subjects, with 26 (15%) cases of PE. SubJects with PE were significantly older (56 vs 41 years. 99% CI for difference of 15 years [6 to 25 years]), were more likely to report unexplained dyspnea (92% vs 69% 99% CI for difference of 23% [7% to 40%]), and waited longer after symptom onset to seek medical evaluation (73 vs 36 hours. 99% CI for difference of 37 hours [11 to 63 hours]). No difference was found for multiple variables commonly associated with PE. Assignment to risk categories was of limited diagnostic utility. For example, low-risk assignment yielded 85% sensitivity, 20% specificity; high-risk assignment: 31% sensitivity, 85% specificity, with diagnostic accuracy below 80% in both categories. Conclusions: Among outpatients selected for evaluation for PE, further risk stratification demonstrated poor diagnostic utility. Clinical features alone cannot be used to differentiate presence or absence of PE in at-risk ambulatory patients.

AB - Objective: To identify clinical findings and predisposing conditions associated with acute pulmonary embolism (PE) in ambulatory patients being evaluated for PE. Methods: A prospective observational study was conducted. A standardized multicomponent data collection form was administered to ambulatory subjects being evaluated for PE. The diagnosis of PE was confirmed or excluded using a combination of scintillation lung scanning, lower- extremity venous Doppler ultrasonography, and selective use of pulmonary angiography. Results: Data collection was completed for 170 subjects, with 26 (15%) cases of PE. SubJects with PE were significantly older (56 vs 41 years. 99% CI for difference of 15 years [6 to 25 years]), were more likely to report unexplained dyspnea (92% vs 69% 99% CI for difference of 23% [7% to 40%]), and waited longer after symptom onset to seek medical evaluation (73 vs 36 hours. 99% CI for difference of 37 hours [11 to 63 hours]). No difference was found for multiple variables commonly associated with PE. Assignment to risk categories was of limited diagnostic utility. For example, low-risk assignment yielded 85% sensitivity, 20% specificity; high-risk assignment: 31% sensitivity, 85% specificity, with diagnostic accuracy below 80% in both categories. Conclusions: Among outpatients selected for evaluation for PE, further risk stratification demonstrated poor diagnostic utility. Clinical features alone cannot be used to differentiate presence or absence of PE in at-risk ambulatory patients.

KW - Clinical features

KW - Diagnosis

KW - Outpatient

KW - Pulmonary embolism

KW - Risk

UR - http://www.scopus.com/inward/record.url?scp=0038000148&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0038000148&partnerID=8YFLogxK

M3 - Article

VL - 4

SP - 891

EP - 897

JO - Academic Emergency Medicine

JF - Academic Emergency Medicine

SN - 1069-6563

IS - 9

ER -