Safety of the pulmonary embolism rule-out criteria rule: Findings from the Registro Informatizado de la Enfermedad TromboEmbolica venosa (RIETE) registry.
Détails
Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_12D83A2DF633
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Safety of the pulmonary embolism rule-out criteria rule: Findings from the Registro Informatizado de la Enfermedad TromboEmbolica venosa (RIETE) registry.
Périodique
Academic emergency medicine
Collaborateur⸱rice⸱s
RIETE Investigators
Contributeur⸱rice⸱s
Adarraga M.D., Alberich-Conesa A., Alonso-Carrillo J., Amado C., Amorós S., Arcelus J.I., Ballaz A., Barba R., Barbagelata C., Barrón M., Barrón-Andrés B., Blanco-Molina A., Botella E., Chasco L., Criado J., Del Toro J., De Ancos C., De Juana-Izquierdo C., Demelo-Rodríguez P., Díaz-Brasero A.M., Díaz-Simon R., Díaz-Pedroche M.C., Díaz-Peromingo J.A., Dubois-Silva A., Escribano J.C., Espósito F., Falgá C., Farfán-Sedano A.I., Fernández-Capitán C., Fernández-Jiménez B., Fernández-Muixi J., Fernández-Reyes J.L., Font C., Francisco I., Galeano-Valle F., García M.A., García de Herreros M., García-Bragado F., García-Ortega A., Gil-Díaz A., Gómez-Cuervo C., Gómez-Mosquera A.M., Grau E., Guirado L., Gutiérrez J., Hernández-Blasco L., Herreros M., Jaras M.J., Jiménez R., Jiménez D., Jou I., Joya M.D., Lacruz B., Lalueza A., Lainez-Justo S., Latorre-Díez A., Lecumberri R., Lobo J.L., López-De la Fuente M., López-Jiménez L., López-Miguel P., López-Núñez J.J., López-Reyez R., López-Ruiz A., López-Sáez J.B., Lorente M.A., Lorenzo A., Lumbierres M., Madridano O., Maestre A., Mas-Maresma L., Marcos M., Martín-Guerra J.M., Martín-Martos F., Mellado M., Mena E., Mencía B., Mercado M.I., Moisés J., Monreal M., Muñoz-Blanco A., Muñoz-Gamito G., Nieto J.A., Núñez-Fernández M.J., Osorio J., Otalora S., Pacheco-Gómez N., Parra P., Pedrajas J.M., Pérez-Ductor C., Pérez-Pérez J.L., Peris M.L., Pesce M.L., Porras J.A., Poyo-Molina J., Puchades R., Riera-Mestre A., Rivera-Civico F., Rivera-Gallego A., Roca M., Rosa V., Rodríguez-Cobo A., Rubio C.M., Ruiz-Giménez N., Ruiz-Ruiz J., Ruiz-Torregrosa P., Salgueiro G., Sancho T., Sendín V., Sigüenza P., Soler S., Suárez-Rodríguez B., Suriñach J.M., Tiberio G., Tolosa C., Torres M.I., Trujillo-Santos J., Uresandi F., Usandizaga E., Valle R., Varona J.F., Vela L., Vela J.R., Vidal G., Villalobos A., Villares P., Ay C., Nopp S., Pabinger I., Vanassche T., Verhamme P., Verstraete A., Hhb Y., Arguello J.D., Montenegro A.C., Roa J., Hirmerova J., Malý R., Accassat S., Bertoletti L., Bura-Riviere A., Catella J., Chopard R., Couturaud F., Espitia O., Grange C., Leclercq B., Mahé I., Moustafa F., Plaisance L., Poenou G., Sarlon-Bartoli G., Suchon P., Versini E., Schellong S., Braester A., Brenner B., Kenet G., Najib D., Tzoran I., Moosavi J., Sadeghipour P., Basaglia M., Bilora F., Bortoluzzi C., Brandolin B., Colaizzo D., Dentali F., Di Micco P., Grandone E., Imbalzano E., Merla S., Pesavento R., Prandoni P., Scarinzi P., Siniscalchi C., Taflaj B., Visonà A., Vo Hong N., Zalunardo B., Dzirnieks K., Kigitovica D., Skride A., Fonseca S., Manuel M., Meireles J., Bosevski M., Trajkova M., Zdraveska M., Bounameaux H., Aujayeb A., Caprini J.A., Weinberg I., Bui H.M.
ISSN
1553-2712 (Electronic)
ISSN-L
1069-6563
Statut éditorial
Publié
Date de publication
09/2023
Peer-reviewed
Oui
Volume
30
Numéro
9
Pages
935-945
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Résumé
The diagnostic strategy for pulmonary embolism (PE) includes a D-dimer test when PE probability is low or intermediate, but false-positive D-dimer results are frequent and can result in an unnecessary computed tomography pulmonary angiogram. The PE rule-out criteria (PERC) rule excludes PE without D-dimer testing when pretest probability is <15%. The aim of this study was to assess the safety of the PERC rule strategy in patients included in the Registro Informatizado de la Enfermedad TromboEmbolica venosa (RIETE) registry.
This retrospective cohort study used data from the RIETE registry, an ongoing, international prospective registry of patients with objectively confirmed venous thromboembolism. The primary outcome was the failure rate of the PERC strategy, represented by the proportion of PERC-negative (PERC-N) patients with a PE included in the registry. Secondary outcomes were a comparison of the clinical characteristics, treatment strategy, and outcome of PERC-N versus PERC-positive (PERC-P) patients at 3 months.
From 2001 to 2021, a total of 49,793 patients with acute PE were enrolled in the RIETE registry. We included 48,903 in the final analysis after exclusion of 890 patients with an undetermined PERC status. Only 346 patients were PERC-N with a failure rate of 0.7% (95% confidence interval 0.6%-0.8%). PERC-N patients presented more frequently with chest pain but less often with dyspnea, syncope, or hypotension. They also had subsegmental or segmental PE more frequently, were more often treated with direct oral anticoagulants, and received mechanical or pharmacological thrombolysis less often. In addition, PERC-N patients had a lower incidence of recurrent deep vein thrombosis, major bleeding, and death attributed to PE during the 3-month follow-up.
A low failure rate of the PERC rule was observed in the RIETE registry, thus supporting its use to safely identify patients with an unlikely probability of PE.
This retrospective cohort study used data from the RIETE registry, an ongoing, international prospective registry of patients with objectively confirmed venous thromboembolism. The primary outcome was the failure rate of the PERC strategy, represented by the proportion of PERC-negative (PERC-N) patients with a PE included in the registry. Secondary outcomes were a comparison of the clinical characteristics, treatment strategy, and outcome of PERC-N versus PERC-positive (PERC-P) patients at 3 months.
From 2001 to 2021, a total of 49,793 patients with acute PE were enrolled in the RIETE registry. We included 48,903 in the final analysis after exclusion of 890 patients with an undetermined PERC status. Only 346 patients were PERC-N with a failure rate of 0.7% (95% confidence interval 0.6%-0.8%). PERC-N patients presented more frequently with chest pain but less often with dyspnea, syncope, or hypotension. They also had subsegmental or segmental PE more frequently, were more often treated with direct oral anticoagulants, and received mechanical or pharmacological thrombolysis less often. In addition, PERC-N patients had a lower incidence of recurrent deep vein thrombosis, major bleeding, and death attributed to PE during the 3-month follow-up.
A low failure rate of the PERC rule was observed in the RIETE registry, thus supporting its use to safely identify patients with an unlikely probability of PE.
Mots-clé
Humans, Retrospective Studies, Venous Thrombosis/diagnosis, Pulmonary Embolism/diagnosis, Pulmonary Embolism/therapy, Venous Thromboembolism/diagnosis, Venous Thromboembolism/epidemiology, Registries, PERC, RIETE, diagnostic algorithm, pretest probability, pulmonary embolism, pulmonary embolism rule-out criteria rule
Pubmed
Web of science
Open Access
Oui
Création de la notice
01/05/2023 9:34
Dernière modification de la notice
19/12/2023 8:17
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