Effectiveness of the YEARS Algorithm Added to Classical Clinical Decision-making Rules in Suspected Pulmonary Embolism
Objective: Pulmonary embolism (PE) is usually non-specific in terms of symptoms and signs and needs to be confirmed by an objective test. Pulmonary computed tomography angiography (PCTA) has been widely used for diagnosis in recent years. Our aim was to evaluate the potential of the YEARS algorithm...
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| Format: | Article |
| Language: | English |
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Türkiye Acil Tıp Vakfı
2024-08-01
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| Series: | Global Emergency and Critical Care |
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| Online Access: | https://globemcc.com/articles/effectiveness-of-the-years-algorithm-added-to-classical-clinical-decision-making-rules-in-suspected-pulmonary-embolism/doi/globecc.galenos.2023.38039 |
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| author | Handan Özen Olcay Şeref Kerem Çorbacıoğlu Emine Emektar Yunsur Çevik |
| author_facet | Handan Özen Olcay Şeref Kerem Çorbacıoğlu Emine Emektar Yunsur Çevik |
| author_sort | Handan Özen Olcay |
| collection | DOAJ |
| description | Objective: Pulmonary embolism (PE) is usually non-specific in terms of symptoms and signs and needs to be confirmed by an objective test. Pulmonary computed tomography angiography (PCTA) has been widely used for diagnosis in recent years. Our aim was to evaluate the potential of the YEARS algorithm to reduce the need for PCTA compared with the classical algorithm.
Materials and Methods: This prospective observational study. Between 15.03.2018 and 15.09.2019, patients admitted to the emergency department with suspected PE who underwent PCTA according to the classical algorithm (Wells) were included in the study. YEARS criteria were reviewed according to the patients’ files and general laboratory results without knowing the results of PCTA. The need for PCTA was investigated according to classical clinical decision-making rules and YEARS algorithms.
Results: The study included 300 patients. According to YEARS, 69% of patients required PCTA, whereas 31% required the YEARS PE exclusion group. According to YEARS, PE was detected in 16.4% of patients with an indication for PCTA, whereas only 2.2% of patients in the PCTA exclusion group had PE. In the patient cohort that included the “probable PE” group according to the Wells, the sensitivity according to the YEARS was 94.4%.
Conclusion: In this study, the YEARS protocol used in addition to the classical algorithm resulted in a 31% reduction in the need for PCTA. However, we also showed that the YEARS algorithm may be insufficient for the diagnosis of low rate, positive PE. |
| format | Article |
| id | doaj-art-69a39cbc39564abb9fe5b07bc00a86b1 |
| institution | OA Journals |
| issn | 2822-4078 |
| language | English |
| publishDate | 2024-08-01 |
| publisher | Türkiye Acil Tıp Vakfı |
| record_format | Article |
| series | Global Emergency and Critical Care |
| spelling | doaj-art-69a39cbc39564abb9fe5b07bc00a86b12025-08-20T02:32:04ZengTürkiye Acil Tıp VakfıGlobal Emergency and Critical Care2822-40782024-08-0132586210.4274/globecc.galenos.2023.38039Effectiveness of the YEARS Algorithm Added to Classical Clinical Decision-making Rules in Suspected Pulmonary EmbolismHandan Özen Olcay0https://orcid.org/0000-0002-1634-2684Şeref Kerem Çorbacıoğlu1https://orcid.org/0000-0001-7802-8087Emine Emektar2https://orcid.org/0000-0002-6056-4401Yunsur Çevik3https://orcid.org/0000-0003-1325-0909Ankara Atatürk Sanatoryum Training and Research Hospital Clinic of Emergency Medicine, Ankara, TürkiyeAnkara Atatürk Sanatoryum Training and Research Hospital Clinic of Emergency Medicine, Ankara, TürkiyeAnkara Atatürk Sanatoryum Training and Research Hospital Clinic of Emergency Medicine, Ankara, TürkiyeAnkara Atatürk Sanatoryum Training and Research Hospital Clinic of Emergency Medicine, Ankara, TürkiyeObjective: Pulmonary embolism (PE) is usually non-specific in terms of symptoms and signs and needs to be confirmed by an objective test. Pulmonary computed tomography angiography (PCTA) has been widely used for diagnosis in recent years. Our aim was to evaluate the potential of the YEARS algorithm to reduce the need for PCTA compared with the classical algorithm. Materials and Methods: This prospective observational study. Between 15.03.2018 and 15.09.2019, patients admitted to the emergency department with suspected PE who underwent PCTA according to the classical algorithm (Wells) were included in the study. YEARS criteria were reviewed according to the patients’ files and general laboratory results without knowing the results of PCTA. The need for PCTA was investigated according to classical clinical decision-making rules and YEARS algorithms. Results: The study included 300 patients. According to YEARS, 69% of patients required PCTA, whereas 31% required the YEARS PE exclusion group. According to YEARS, PE was detected in 16.4% of patients with an indication for PCTA, whereas only 2.2% of patients in the PCTA exclusion group had PE. In the patient cohort that included the “probable PE” group according to the Wells, the sensitivity according to the YEARS was 94.4%. Conclusion: In this study, the YEARS protocol used in addition to the classical algorithm resulted in a 31% reduction in the need for PCTA. However, we also showed that the YEARS algorithm may be insufficient for the diagnosis of low rate, positive PE.https://globemcc.com/articles/effectiveness-of-the-years-algorithm-added-to-classical-clinical-decision-making-rules-in-suspected-pulmonary-embolism/doi/globecc.galenos.2023.38039pulmonary embolismyears algorithmwells criteria |
| spellingShingle | Handan Özen Olcay Şeref Kerem Çorbacıoğlu Emine Emektar Yunsur Çevik Effectiveness of the YEARS Algorithm Added to Classical Clinical Decision-making Rules in Suspected Pulmonary Embolism Global Emergency and Critical Care pulmonary embolism years algorithm wells criteria |
| title | Effectiveness of the YEARS Algorithm Added to Classical Clinical Decision-making Rules in Suspected Pulmonary Embolism |
| title_full | Effectiveness of the YEARS Algorithm Added to Classical Clinical Decision-making Rules in Suspected Pulmonary Embolism |
| title_fullStr | Effectiveness of the YEARS Algorithm Added to Classical Clinical Decision-making Rules in Suspected Pulmonary Embolism |
| title_full_unstemmed | Effectiveness of the YEARS Algorithm Added to Classical Clinical Decision-making Rules in Suspected Pulmonary Embolism |
| title_short | Effectiveness of the YEARS Algorithm Added to Classical Clinical Decision-making Rules in Suspected Pulmonary Embolism |
| title_sort | effectiveness of the years algorithm added to classical clinical decision making rules in suspected pulmonary embolism |
| topic | pulmonary embolism years algorithm wells criteria |
| url | https://globemcc.com/articles/effectiveness-of-the-years-algorithm-added-to-classical-clinical-decision-making-rules-in-suspected-pulmonary-embolism/doi/globecc.galenos.2023.38039 |
| work_keys_str_mv | AT handanozenolcay effectivenessoftheyearsalgorithmaddedtoclassicalclinicaldecisionmakingrulesinsuspectedpulmonaryembolism AT serefkeremcorbacıoglu effectivenessoftheyearsalgorithmaddedtoclassicalclinicaldecisionmakingrulesinsuspectedpulmonaryembolism AT emineemektar effectivenessoftheyearsalgorithmaddedtoclassicalclinicaldecisionmakingrulesinsuspectedpulmonaryembolism AT yunsurcevik effectivenessoftheyearsalgorithmaddedtoclassicalclinicaldecisionmakingrulesinsuspectedpulmonaryembolism |