0
Correspondence |

Analysis of National Trends in Admissions for Pulmonary Embolism FREE TO VIEW

Carla Nobre, MD; Boban Thomas, MD, FCCP
Author and Funding Information

Editor’s Note: Authors are invited to respond to Correspondence that cites their previously published work. Those responses appear after the related letter. In cases where there is no response, the author of the original article declined to respond or did not reply to our invitation.

FINANCIAL/NONFINANCIAL DISCLOSURES: None declared.

aCentro Hospitalar Barreiro Montijo, Barreiro, Portugal

bOur Lady's Hospital, Navan, Ireland

CORRESPONDENCE TO: Boban Thomas, MD, FCCP, Department of Medicine/Cardiology, Our Lady’s Hospital, Navan, Ireland


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;150(1):250. doi:10.1016/j.chest.2016.04.024
Text Size: A A A
Published online

We read with interest the analysis of National Trends in Admissions for Pulmonary Embolism by Smith et al published in this issue of CHEST. The authors hypothesized that their findings reflected a movement toward admissions for less severe pulmonary embolism (PE). They also noted appropriately that increased admission rates may be related to the increased sensitivity and frequency of use of pulmonary CT angiography.

We were concerned about one issue not addressed adequately in the analysis. It is obvious that any test that is very sensitive will account for some diagnoses that are actually false-positive diagnoses. We are concerned that a large number of these subsegmental emboli are actually false-positive diagnoses, and this is probably substantiated by the decrease in the median length of stay and may also be reflected in the decrease in mortality.

A recent study demonstrated substantial discordance between an original diagnostic report and the opinion of an expert panel on second reading. Discordance increased with the segmental and subsegmental group. Almost 27% of initially diagnosed segmental PEs and 60% of subsegmental PEs were considered negative on a second review.

If some patients who were admitted indeed did not have PE, it is a cause for concern.

References

Smith S.B. .Geske J.B. .Kathuria P. .et al Analysis of national trends in admissions for pulmonary embolism. Chest. 2016;150:35-45 [PubMed]journal
 
Hutchinson B.D. .Navin P. .Marom E.M. .Truong M.T. .Bruzzi J.F. . Overdiagnosis of Pulmonary Embolism by Pulmonary CT Angiography. AJR Am J Roentgenol. 2015;205:271-277 [PubMed]journal. [CrossRef] [PubMed]
 

Figures

Tables

References

Smith S.B. .Geske J.B. .Kathuria P. .et al Analysis of national trends in admissions for pulmonary embolism. Chest. 2016;150:35-45 [PubMed]journal
 
Hutchinson B.D. .Navin P. .Marom E.M. .Truong M.T. .Bruzzi J.F. . Overdiagnosis of Pulmonary Embolism by Pulmonary CT Angiography. AJR Am J Roentgenol. 2015;205:271-277 [PubMed]journal. [CrossRef] [PubMed]
 
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543