Prevalence
Clinical
features
Differential
Diagnosis
Investigations
Therapy
Prevention
Prognosis
|  | | | Investigations |
Pulmonary angiography
a
Why?
-
Pulmonary angiography is the reference standard for pulmonary embolism - however around 3% of tests are non-diagnostic
c
-
However minor complications (urticaria, pruritis; mild renal dysfunction) occur in 5%.
c
-
1% of patients have major complications (respiratory distress requiring CPR or
intubation; renal failure requiring dialysis; haematoma requiring transfusion of 2+ units) or die
c
Pulmonary angiography can diagnose and exclude pulmonary embolism
| Patient |
Target Disorder and
Reference Standard |
Diagnostic Test |
LR+
(95% CI)
|
Post-test Probability |
LR-
(95% CI)
|
Post-test Probability |
|
suspected pulmonary embolism
c
(pre-test probability: 21%)
|
pulmonary embolism
(follow-up or autopsy)
|
pulmonary angiography
|
170
(64 to
450)
|
99% |
0.0026
(0.00037 to
0.019)
|
0.15% |
Pulmonary angiography can have serious complications
|
Complications c
|
%
(95% CI)
|
non-diagnostic scan
|
3.2%
(2.1% to 4.2%)
|
deaths
|
0.45%
(0.06% to 0.84%)
|
major complications
|
0.81%
(0.28% to 1.3%)
|
minor complications
|
5.4%
(4.1% to 6.7%)
|
|
internal medicine