Incidence of pulmonary embolism in an emergency department cohort evaluated with a simple symptom-based diagnostic algorithm.

BACKGROUND Although complex scores were recommended for diagnosis of pulmonary embolism (PE), acceptance in clinical practice is limited. In our Emergency Department a symptom-based algorithm for patients with suspected PE including computed tomographic pulmonary angiography (CTPA) and D-dimer testing was implemented. PATIENTS AND METHODS The cases of 492 patients presenting with either chest pain, dyspnea or syncope for whom this algorithm was applied, were retrospectively analyzed with respect to the incidence of PE, D-dimer and high-sensitive troponin levels. RESULTS Our algorithm detected PE in 59 out of 492 patients. D-Dimer levels were significantly higher in the PE group than in the patients without PE (p<0.0001). High-sensitive troponin was significantly increased in patients with central PE compared to other patients (p<0.01). CONCLUSION Our data demonstrate the utility and practicability of our symptom-based algorithm in combination with D-dimer testing and the use of CTPA in patients with suspected PE.