{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T06:08:40Z","timestamp":1771654120805,"version":"3.50.1"},"reference-count":21,"publisher":"BMJ","issue":"9","funder":[{"name":"The Eli Lilly Foundation Physician Scientist Award"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>We sought to determine clinical variables in children tested for suspected pulmonary embolism (PE) that predict PE+ outcome for the development of paediatric PE prediction rule.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were collected by query of a laboratory database for D-dimer from January 2004 to December 2014 for a large multicentre hospital system and the radiology database for pulmonary vascular imaging in children aged 5\u201317. Using explicit, predefined methods, trained abstractors, determined if D-dimer was sent in the evaluation of PE and then recorded predictor data which was tested for association with PE+ outcome using univariate techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>D-dimer was ordered in 526 children for clinical suspicion of PE. Thirty-four of 526 were PE+ (6.4%, 95%\u2009CI 4.3% to 8.7%). The radiology database identified 17 additional patients with PE (n=51\u2009PE+ total). Children evaluated for PE were primarily in the ED setting (80%), teenagers (88%) and 2:1 female:male. Children with PE had higher mean heart and higher respiratory rate and a lower pulse oximetry and haemoglobin concentration. On univariate analysis, five conditions were more frequent in PE+ compared with no PE: surgery, central line, limb immobility, prior PE or deep vein thrombosis and cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The rate of PE diagnosis in children with D-dimer was 6.4%, similar to that seen in adults; most children with PE are over 13 years and had clinical predictors known to increase probability of PE in symptomatic adults. Future studies should use these criteria to develop a clinical decision rule for PE in children.<\/jats:p><\/jats:sec>","DOI":"10.1136\/archdischild-2017-313317","type":"journal-article","created":{"date-parts":[[2017,11,8]],"date-time":"2017-11-08T17:15:34Z","timestamp":1510161334000},"page":"835-840","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Clinical characteristics of children evaluated for suspected pulmonary embolism with D-dimer testing"],"prefix":"10.1136","volume":"103","author":[{"given":"Jessica","family":"Kanis","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Pike","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cassandra L","family":"Hall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey A","family":"Kline","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,11,8]]},"reference":[{"key":"2020050712450720000_103.9.835.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2004.06.021"},{"key":"2020050712450720000_103.9.835.2","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1182\/blood.V83.5.1251.1251","article-title":"Venous thromboembolic complications (VTE) in children: first analyses of the Canadian Registry of VTE","volume":"83","author":"Andrew","year":"1994","journal-title":"Blood"},{"key":"2020050712450720000_103.9.835.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2005.05.013"},{"key":"2020050712450720000_103.9.835.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2008.07243.x"},{"key":"2020050712450720000_103.9.835.5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2009.03572.x"},{"key":"2020050712450720000_103.9.835.6","doi-asserted-by":"publisher","DOI":"10.1055\/s-2003-42589"},{"key":"2020050712450720000_103.9.835.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2004.04.002"},{"key":"2020050712450720000_103.9.835.8","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-135-2-200107170-00010"},{"key":"2020050712450720000_103.9.835.9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2004.00790.x"},{"key":"2020050712450720000_103.9.835.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2007.04.026"},{"key":"2020050712450720000_103.9.835.11","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2012-201730"},{"key":"2020050712450720000_103.9.835.12","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-0126"},{"key":"2020050712450720000_103.9.835.13","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.jpeds.2016.07.046","article-title":"Detection of pulmonary embolism in high-risk children","volume":"178","author":"Hennelly","year":"2016","journal-title":"J Pediatr"},{"key":"2020050712450720000_103.9.835.14","doi-asserted-by":"crossref","unstructured":"Kanis J , Hall CL , Pike J , et al . 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