PERCEPIC: PERC Rule Combined With Implicit Low Clinical Probability
Pulmonary EmbolismDyspnea1 morePERC rule was created to rule out pulmonary embolism (PE) without further exams, with residual PE risk <2%. Its safety is currently confirmed in low PE prevalence populations as north-American. In European high PE prevalence population, it has been showed that PERC rule used alone or associated with low clinical probability assessed by revised Geneva score (RGS) was not safe. In retrospective study, we suggest that the combination of PERC rule with implicit clinical probability (gestalt) could allow the use of the PERC rule. PERCEPIC, an observational prospective multicenter study performed in France and Belgium, will test this hypothesis. Therefore, 3000 patients will be included in 12 centers. Primary outcome will be the rate of thromboembolic events or death related or possibly related to PE in patients with low implicit clinical probability and negative PERC rule (8 criteria absents). Upper limit of confidence interval of this rate must be equal or lower than 3% to consider PERC rule as safe in this combination.
Registry of Hospitalized Patients Treated With Fondaparinux
Deep Vein ThrombosisPulmonary EmbolismRegistry of Hospitalized patients at Brigham and Women's Hospital treated with Fondaparinux
Multi-Center Human Alert Trial to Prevent DVT and PE
Pulmonary EmbolismDeep Vein Thrombosis2 moreTo evaluate physician response to human alerts that inform the clinician that his/her patient may be eligible for thromboprophylaxis. Medical records are reviewed to evaluate prescribing decision and to evaluate rates of venous thromboembolism.
Study of IVC Filter Retrieval With the Günther Tulip Vena Cava Filter
Pulmonary EmbolismVenous ThromboembolismThe purpose of this study is to test the hypothesis that the Günther Tulip Vena Cava Filter can be removed after a period of implantation, when implanted in patients for the prevention of pulmonary thromboembolism.
Magnetic Resonance Diagnosis of Pulmonary Embolism
Lung DiseasesPulmonary EmbolismThe purpose of this study is to evaluate the diagnostic accuracy of thoracic magnetic resonance imaging with gadolinium-enhanced, unenhanced and perfusion sequences in patients with clinically suspected acute pulmonary embolism Thoracic CT angiography (CTA) will serve as reference standard Result of MRI will not interfere with patients' management Untreated patients with negative CTA will have 3-month follow-up to verify they were free of thrombose-embolic disease
Evaluating Right Ventricular (RV) Size and Function Using the Upper Valley RV Algorithm and Novel...
Pulmonary HypertensionValvular Heart Disease4 moreThe primary purpose of this study is to evaluate the diagnostic performance of three methods for measuring right ventricular size and function including the Philips Novel RV quantification technologies (RV Heart Model volumetric analysis and Philips 2D strain) and the Upper Valley Right Ventricle Algorithm (UVRV) algorithm as compared to the gold standard of volumetric analysis via cardiac magnetic resonance imaging (CMR) in a broad patient population.
Prevalence Rate of Pulmonary Embolism Among Not Anticoagulated Patients
Pulmonary EmbolismThe purpose of this study is to evaluate the prevalence rate of pulmonary embolism among not anticoagulated patient older than 75 years old admitted with syncope and hospitalised in the Toulon Hospital
Deep Venous Thrombosis After Hepatobiliopancreatic Surgery
Venous ThrombosisPulmonary Embolism2 moreTo investigate the incidence of pre- and early postoperative deep venous thrombosis in patients undergoing hepatobiliopancreatic surgery, as well as potential corresponding risk factors with special attention to circulating tumor cells.
Improving the Stewardship of Diagnostic Imaging Resources in Alberta Emergency Departments
Brain InjuriesPulmonary EmbolismUtilization of diagnostic imaging in the Emergency Department has increased dramatically over the past two decades, driven by an increased availability of advanced imaging, legal pressures to exclude serious diagnoses in low-risk patients, patient expectations, and the tendency to associate more testing with a higher quality of care. However, this rise in the use of diagnostic imaging, particularly in low-risk patients, may not be taking into account the risk of radiation exposure to patients, or the impact on finite health system resources. The objective of this project is to improve the appropriateness of CT imaging in Alberta Emergency Departments by advancing awareness of, and adherence to, evidence-based guidelines for CT imaging of patients with mild traumatic brain injury (MTBI) and suspected pulmonary embolism (PE). These two clinical scenarios have been selected because of evidence of significant variation in imaging practices across Alberta, and the robust evidence base that exists to guide CT imaging decisions such as the Canadian CT Head Rule and the Pulmonary Embolism Rule Out Criteria.
Implementing a Tool to Identify Risk for Venous Thromboembolism in Cancer Patients
Venous ThromboembolismDeep-Vein Thrombosis2 moreCancer increases the risk of deep vein blood clots and clots traveling to the lungs (emboli) which cause morbidity (leg swelling, pain, and shortness of breath), sudden death, delays cancer treatment, and decreases cancer survival by 66% compared to similar cancer patients without blood clots. Blood thinners may prevent clots but major bleeding is also a problem, so preventive therapies are not used routinely. Identifying patients at highest risk for clots is critical. A tool exists but it has not been used outside of research. We propose to study how to apply this tool in clinical practice and test if it works.