{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T07:53:20Z","timestamp":1784447600691,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,9,4]],"date-time":"2022-09-04T00:00:00Z","timestamp":1662249600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The heterogeneity of inpatient pulmonary embolism (PE) presentations may lead to computed tomography pulmonary angiograms (CTPA) being over\u2010requested. Current clinical predictors for PE, including Wells criteria and Pulmonary Embolism Rule\u2010out Criteria (PERC), have predominantly focussed on outpatient and emergency department populations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine the clinical indicators for ordering inpatient CTPA and the predictors of positive scans for PE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive inpatient CTPA (performed &gt;24 h after admission) from January 2017 to December 2017 were retrospectively reviewed. Variables including baseline characteristics, vital signs and risk factors for PE were extracted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 312 CTPA was reviewed (average patient age 67\u2009years; 46% male) and 36 CTPA were positive for PE (11.5%). The average time to inpatient CTPA request was 7\u2009days. Clinical indicators associated with positive scans were hypoxia (odds ratio (OR) 2.4; 95% confidence interval (CI) 1.1\u20135.6), tachypnoea (OR 2.5; 95% CI 1.2\u20136.0), recent surgery or immobilisation (OR 2.7; 95% CI 1.2\u20136.4), S1Q3T3 pattern on electrocardiogram (ECG; OR 7.2; 95% CI 1.4\u201335.7) and right bundle branch block pattern on ECG (OR 4.7; 95% CI 1.6\u201313.1). Hypotension, fever and malignancy were not significant. Both PERC and Wells criteria had poor positive predictive value (12% and 27% respectively), but the negative predictive value for PERC and Wells was 100% and 95.8% respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Inpatient CTPA appear to be over\u2010requested and can potentially be rationalised based on a combination of clinical predictors and Wells criteria and\/or PERC rule. Further prospective studies are needed to develop accurate clinical decision tools targeted towards inpatients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.15696","type":"journal-article","created":{"date-parts":[[2022,1,20]],"date-time":"2022-01-20T12:50:25Z","timestamp":1642683025000},"page":"1224-1230","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical predictors of pulmonary embolism for inpatients: are computed tomography pulmonary angiograms being requested appropriately?"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6938-0043","authenticated-orcid":false,"given":"Lisa Luo\u2010Lan","family":"Ling","sequence":"first","affiliation":[{"name":"Department of Haematology Northern Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor Jia Wei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Haematology Northern Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui Yin","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Haematology Northern Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming Joe","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Radiology Northern Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prahlad","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Haematology Northern Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,4]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz405"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH17-08-0531"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00194213"},{"key":"e_1_2_6_5_1","unstructured":"Access Economics Pty LimitedThe Burden of Venous Thromboembolism in Australia. 2008 [cited 2019 Jul 15]. 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