Characteristics of Patients With Missed Pulmonary Embolism in the ED: A Three Year Experience
Missed Pulmonary Embolism at the Emergency DepartmentThe clinical presentation of acute pulmonary embolism ranges from mild dyspnea and cough to shock or sustained hypotension but it also may even be asymptomatic and diagnosed by imaging procedures performed for other purposes. (1) Depending on the clinical presentation, the case fatality rate for acute pulmonary embolism ranges from 1% up to 60%. Due to the often non-specific presentation, especially in mild to moderate acute pulmonary embolism PE is often underdiagnosed. Chest pain and shortness of breath are the two most common symptoms associated with pulmonary embolism, together these symptoms are responsible for approximately 10 million emergency department visits in the United States of America (US) (2). The aim of this study was to determine the sensitivity and specificity of diagnosing pulmonary embolism (PE) at the emergency department (ED) of the University Hospital Basel and the investigators have therefore retrospectively analyzed all cases with excluded or proven PE in our institution in the last three years. Data sets from the institute of radiology, the institute of pathology and the ED are consistently available from January 2011 until the present day and were screened for pulmonary embolism in discharge reports. Data from the ED include all patients between January 2011 and December 2013 that presented to the ED and received either an ECG or any form of thoracic imaging. Particular attention was paid to patients with PE in the discharge report. The third set of data includes all patients with PE as cause of death or as a secondary diagnosis in the autopsy report. After comparing the three sets of data to each other the investigators tried to determine the sensitivity and specificity of PE diagnosis at the ED respectively the rate of missed diagnoses. A PE was seen as missed if it is detected 24h after the patient presented to the ED or if it was detected at another department after the patient was transferred from the ED.
Development of a Questionnaire to Assess Patient Knowledge About Non-vitamin K Anticoagulants (NOAC)...
Atrial FibrillationPulmonary Embolism1 morePharmacists are in the best position to counsel and educate patients on anticoagulant agents such as NOACs. This should enable patients to play a more active role in their treatment and ultimately enhance adherence behaviour. However, educational elements should be targeted to knowledge. Thus, the investigators will develop and validate a questionnaire that can assess knowledge about NOACs
Validation of Epworth Richmond's Echocardiography Education Focused Year
ShockCardiogenic3 moreThe use of echocardiography in intensive care is a developing field. In expert hands echocardiography has proven its utility in diagnosing cardiac pathology, differentiating shock states and in haemodynamic monitoring. However, whether the results obtained by experts can be generalized to trainees or specialists with limited training remains unclear. Further, concerns around training time and cost for intensive care staff have been a factor in limiting the uptake of echocardiography in intensive care. The investigators aim to assess the diagnostic accuracy of Australian ICU doctors in training after completion of the current minimum training. After completing a structured teaching program and 30 mentored training scans trainees will be assessed on their accuracy with echocardiography. In the research phase trainees will complete a further 40 scans with each one matched with an expect scan. The results from the expert and trainee scans will be compared to determine the trainee's accuracy.
Non-invasive Diagnosis of Pulmonary Embolism by Use of Biomarkers in Exhaled Breath Condensate
Pulmonary EmbolismIn this study, a new, non-invasive method for diagnosis of pulmonary embolism (PE) will be tested. In pre-clinical studies, we have identified 151 putative biomarkers for pulmonary embolism in the exhaled breath condensate (EBC). These biomarkers needs validation/consolidation in a clinical setting before further test of this new diagnostic method.
Contemporary Clinical Management Of Acute Pulmonary Embolism
Acute Pulmonary EmbolismAcute pulmonary embolism is a potentially life-threatening disease with short-term mortality ranges from less than 1% to more than 30% during the hospital stay. Recent guidelines recommend to tailor diagnosis hospitalization and acute treatment based on the estimated risk for short-term Death. The assessment of the contemporary clinical management of patients with acute pulmonary embolism across different specialties would be of crucial value.
Risk of Venous Thromboembolism in Critically Ill Patients With Severe COVID-19
COVID-19Critical Illness9 moreSevere COVID-19 patients at a high risk of venous thromboembolism. We studied patients in 2 intensive care units of university hospitals in Barcelona and Badalona, Spain. We performed a cut-off screening of deep venous thrombosis (DVT) with bilateral duplex ultrasound to 230 patients.
Pulmonary Embolism in Exacerbations of Chronic Obstructive Pulmonary Disease
Pulmonary EmbolismChronic Obstructive Pulmonary DiseaseThe purpose of this study is to determine the prevalence of pulmonary embolism in our population of Chronic Obstructive Pulmonary Disease (COPD) patients admitted to hospital with dyspnea. The patients will undergo investigation for pulmonary embolism, according to current guidelines.
Risk of Pulmonary and Venous Thromboembolism in Pregnancies After in Vitro Fertilization
Pulmonary EmbolismVenous ThromboembolismOccurrence of venous thromboembolism during in Vitro Fertilization (IVF) pregnancies has been reported in numerous case reports and in two small consecutive series. The incidence of venous thromboembolism (VTE) after IVF has been claimed to be comparable to the incidence of VTE during normal pregnancy. No information exists concerning pulmonary embolism (PE). The aim is to estimate and compare the risk of both PE and VTE during the the different phases of pregnancy after IVF to that in age and period matched control women. The investigators will use the Swedish National Health Registers to estimate the risk.
V/Q SPECT for Diagnosis of Pulmonary Embolism
Pulmonary EmbolismThe objective of the study was to assess diagnostic performance of V/Q SPECT for the diagnosis of pulmonary embolism by comparing V/Q SPECT results to a validated diagnostic strategy.
Study on Thrombosis Therapy in German Cancer Patients
CancerDeep Vein Thrombosis1 moreThe study aims to document the flow of German patients with cancer and acute deep vein thrombosis from first visit to diagnosis and treatment, the applied diagnostic procedures, and therapy modalities.