We have located links that may give you full text access.
JOURNAL ARTICLE
RESEARCH SUPPORT, NON-U.S. GOV'T
The low-probability lung scan. A need for change in nomenclature.
Archives of Internal Medicine 1995 September 26
BACKGROUND: The prognosis in patients with suspected pulmonary embolism who have a low-probability lung scan has been the focus of much clinical debate. This is particularly so in patients with underlying cardiac and pulmonary disease, because these disorders frequently cause low-probability lung scans in the absence of pulmonary embolism. Historically, the clinical response has been to exclude pulmonary embolism and withhold treatment on the basis of a low-probability lung scan, which has been regarded as synonymous with a good prognosis.
METHODS: A prospective cohort-analytic study to evaluate prognosis, using long-term follow-up, in patients with inadequate cardiorespiratory reserve who have presented with suspected pulmonary embolism (inadequate cardiorespiratory reserve, ie, pulmonary edema, right-ventricular failure, hypotension, syncope, acute tachyarrhythmia, abnormal spirometry [forced expiratory volume in 1 second, < 1.0, or vital capacity, < 1.5 L], or abnormal arterial blood gases [PO2, < 50 mm Hg, or PCO2, > 45 mm Hg]).
RESULTS: The outcomes of the 77 consecutive patients with low-probability lung scans, suspected pulmonary embolism, and inadequate cardiorespiratory reserve were compared with those in 711 consecutive patients with good cardiorespiratory reserve and nondiagnostic lung scans who were entered into the study over the same period of time. Six (7.8%) of the 77 patients died within days of entry with autopsy-proven pulmonary embolism compared with one (0.14%) of the 711 patients with nondiagnostic lung scans (P < .0001).
CONCLUSIONS: Our findings indicate that the term low-probability lung scan should be abandoned in reference to patients with inadequate cardiorespiratory reserve, because it is not synonymous with a good prognosis and is, indeed, misleading.
METHODS: A prospective cohort-analytic study to evaluate prognosis, using long-term follow-up, in patients with inadequate cardiorespiratory reserve who have presented with suspected pulmonary embolism (inadequate cardiorespiratory reserve, ie, pulmonary edema, right-ventricular failure, hypotension, syncope, acute tachyarrhythmia, abnormal spirometry [forced expiratory volume in 1 second, < 1.0, or vital capacity, < 1.5 L], or abnormal arterial blood gases [PO2, < 50 mm Hg, or PCO2, > 45 mm Hg]).
RESULTS: The outcomes of the 77 consecutive patients with low-probability lung scans, suspected pulmonary embolism, and inadequate cardiorespiratory reserve were compared with those in 711 consecutive patients with good cardiorespiratory reserve and nondiagnostic lung scans who were entered into the study over the same period of time. Six (7.8%) of the 77 patients died within days of entry with autopsy-proven pulmonary embolism compared with one (0.14%) of the 711 patients with nondiagnostic lung scans (P < .0001).
CONCLUSIONS: Our findings indicate that the term low-probability lung scan should be abandoned in reference to patients with inadequate cardiorespiratory reserve, because it is not synonymous with a good prognosis and is, indeed, misleading.
Full text links
Related Resources
Trending Papers
Heart failure with preserved ejection fraction: diagnosis, risk assessment, and treatment.Clinical Research in Cardiology : Official Journal of the German Cardiac Society 2024 April 12
Proximal versus distal diuretics in congestive heart failure.Nephrology, Dialysis, Transplantation 2024 Februrary 30
World Health Organization and International Consensus Classification of eosinophilic disorders: 2024 update on diagnosis, risk stratification, and management.American Journal of Hematology 2024 March 30
Efficacy and safety of pharmacotherapy in chronic insomnia: A review of clinical guidelines and case reports.Mental Health Clinician 2023 October
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app