Increased diagnosis of pulmonary embolism without a corresponding decline in mortality during the CT era

Burge, A.J.; Freeman, K.D.; Klapper, P.J.; Haramati, L.B.

doi:10.1016/j.crad.2007.10.004

« Previous Next »Clinical Radiology
Volume 63, Issue 4 , Pages 381-386, April 2008

Increased diagnosis of pulmonary embolism without a corresponding decline in mortality during the CT era

A.J. Burge
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
K.D. Freeman
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
P.J. Klapper
- Department of Internal Medicine, Division of Pulmonary Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
L.B. Haramati
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
- Guarantor and correspondent: L.B. Haramati, Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, 111 East 210th Street, Bronx, New York 10467, USA. Tel.: +1 718 920 7458; fax: +1 718 798 7983.

Received 16 July 2007; received in revised form 14 October 2007; accepted 17 October 2007.

Aim

To determine the association between the increasing computed tomography (CT) use for suspected pulmonary embolism (PE) on the annual rates of PE diagnosis and mortality, using time as a surrogate for CT use.

Materials and Methods

New York State's (NYS) Statewide Planning and Research Cooperative System (SPARCS) database was used to determine the rate of PE diagnosis and mortality between 1 January 1994 and 31 December 2004. Risk factors for PE were investigated. Bivariate and multivariate analyses were performed to determine the relationships between variables.

Results

The study population consisted of 24,871,131 NYS patients. The number of patients with a primary diagnosis of PE nearly doubled over the study period, from 2590 in 1994 to 4920 in 2004, while total admissions remained stable. PE deaths did not vary significantly over time, from 157 in 1994 to 159 in 2004 and did not vary with the diagnoses of PE. Age-adjusted multivariate analysis did not reveal a significant association between the rates of PE diagnosis or mortality and corresponding risk factors.

Conclusion

This study suggests that the increased use of CT in patients with suspected PE has led to an increase in the diagnosis of PE without a corresponding decline in mortality. Further evidence, using data on individual patients, is needed to determine the appropriate role of CT in evaluating patients with suspected PE.