PT Inquest is an online journal club. Hosted by Jason Tuori, Megan Graham, and Chris Juneau, the show looks at an article every week and discusses how it applies to current physical therapy practice.
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Podcast #249: D-Dimer
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Manage episode 186334136 series 1397179
Content provided by medicalminute and Emergency Medical Minute. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by medicalminute and Emergency Medical Minute or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://player.fm/legal.
Author: Michael Hunt, M.D.
Educational Pearls
- In the recent YEARS study, investigators checked every patient with suspicion for PE with a D-dimer, using a modified Wells score for risk stratification. The goal of the study was to show that CT scan usage could safely reduced using this screening method.
- The Wells Criteria measures they used to stratify risk were: PE mostly likely dx, hemoptysis, and evidence of DVT. If the d-dimer was 1, but the patient had none of the Wells criteria, the patient did not get a CT. If the patient had any of the criteria, but the d-dimer was only 0.5, the patient did not get a CT scan.
- The investigators reduced CT usage by 14% using the new criteria, with no significant increase in morbidity and mortality.
References: van der Hulle et al. Simplified diagnostic management of suspected pulmonary embolism (the YEARS study): a prospective, multicentre, cohort study. The Lancet. 2017
1050 episodes
M4A•Episode home
Manage episode 186334136 series 1397179
Content provided by medicalminute and Emergency Medical Minute. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by medicalminute and Emergency Medical Minute or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://player.fm/legal.
Author: Michael Hunt, M.D.
Educational Pearls
- In the recent YEARS study, investigators checked every patient with suspicion for PE with a D-dimer, using a modified Wells score for risk stratification. The goal of the study was to show that CT scan usage could safely reduced using this screening method.
- The Wells Criteria measures they used to stratify risk were: PE mostly likely dx, hemoptysis, and evidence of DVT. If the d-dimer was 1, but the patient had none of the Wells criteria, the patient did not get a CT. If the patient had any of the criteria, but the d-dimer was only 0.5, the patient did not get a CT scan.
- The investigators reduced CT usage by 14% using the new criteria, with no significant increase in morbidity and mortality.
References: van der Hulle et al. Simplified diagnostic management of suspected pulmonary embolism (the YEARS study): a prospective, multicentre, cohort study. The Lancet. 2017
1050 episodes
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