Abstract Number: PB2343
Meeting: ISTH 2020 Congress
Theme: Venous Thromboembolism and Cardioembolism » VTE Epidemiology
Background: There is an impression that North American ED patients tested for PE differ from those who are tested in Europe, based on the low prevalence of PE diagnosis.
Aims: Our aim was to compare the prevalence of PE, the rates of pulmonary imaging and the positive yield of imaging among ED patients tested for PE in Europe and North America.
Methods: We searched MEDLINE and EMBASE for studies reporting consecutive ED patients tested for PE. Two authors screened full texts, performed risk of bias assessment and data extraction. We conducted a meta-analysis of proportions specifying a random-effects model for each outcome. We used multiple meta-regression to evaluate whether the effect of the geographical region was independent of study year.
Results: From 3109 unique publications, 44 were included in the systematic review (23 with low risk of bias). The prevalence of PE in Europe was 23% (95% CI 21%-26%) and North America 8% (95% CI 6%-9%) (Figure1). The odds ratio (OR) for diagnosing PE in the study population in Europe as compared to North America, adjusted for year of study, was 1.16 (95% CI 1.11 – 1.22). Computed tomography pulmonary angiography (CTPA) was used in 59% (95% CI 51%-68%) of European and 38% (95% CI 24%-51%) of North American patients tested for PE (adjusted for year, OR 1.25 (95% CI 0.88 – 1.52)). The CTPA diagnostic yield was 29% (95% CI 26%, 32%) in Europe and 13% (95% CI 9%, 17%) in North America, [adjusted for year, OR 1.16 (95% CI 1.09 – 1.24)] (Figure2).
Conclusions: Compared to North America, European ED studies have a higher prevalence of PE, higher rate of CTPA use and a higher diagnostic yield from CTPA compared to North America. This supports the hypothesis that those tested in North American EDs have a lower risk of PE compared to Europe.
[Figure 1: Forest plot for prevalence of pulmonary embolism.]
[Figure 2: Forest plot for yield of computed tomography pulmonary angiography.]
To cite this abstract in AMA style:
Germini F, Zarabi S, Eventov M, Turcotte M, Li M, de Wit K. Prevalence of Pulmonary Embolism in Patients Accessing the Emergency Department, Reported by Country of Study: A Systematic Review and Meta-analysis [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/prevalence-of-pulmonary-embolism-in-patients-accessing-the-emergency-department-reported-by-country-of-study-a-systematic-review-and-meta-analysis/. Accessed March 21, 2024.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/prevalence-of-pulmonary-embolism-in-patients-accessing-the-emergency-department-reported-by-country-of-study-a-systematic-review-and-meta-analysis/