{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T10:00:48Z","timestamp":1784973648421,"version":"3.55.0"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Egypt Heart J"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pulmonary embolism (PE) remains a complex clinical challenge with significant morbidity and mortality. Despite significant advancements in diagnosis and management, as well as the availability of recent guidelines, disparities in their implementation persist due to socioeconomic factors and other barriers. The study aims to assess the degree of implementation of guidelines in the diagnosis and management of PE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 8,648 patients presenting to the National Heart Institute emergency department, 200 were diagnosed with acute PE, accounting for 2.3% of ED visits during the study period. The mean age was 56.7\u2009\u00b1\u20099.8 years, with 58% being female. Dyspnea was the most common symptom, occurring in 64% of cases, while bed rest for &gt;\u20093 days was the most frequent risk factor (32%). Computed tomography pulmonary angiography (CTPA) confirmed PE in 95.5% of cases. Risk stratification classified 80% as low to intermediate-low risk, 13% as intermediate-high risk, and 6% as high-risk. Unfractionated heparin monotherapy was initiated in 63% of patients, while only 8.5% were discharged on direct oral anticoagulants (DOACs). Mortality was 3%, including 1% due to life-threatening bleeding. There was notable overuse of D-dimer testing, underutilization of ventilation\u2013perfusion (V\/Q) scans, limited prescription of DOACs, and absence of interventional therapies in eligible patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study highlights critical gaps in adherence to PE management guidelines, influenced by physician discretion, socioeconomic constraints, and diagnostic inconsistencies. Strengthening outpatient care pathways, refining risk stratification practices, and ensuring consistent guideline implementation are key priorities to optimize outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s43044-026-00771-2","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T09:11:55Z","timestamp":1784970715000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessment of adherence to acute pulmonary embolism management guidelines: a single-centre registry"],"prefix":"10.1186","volume":"78","author":[{"given":"Hesham Salah Eldin","family":"Taha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noha","family":"Hassanein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heba Mostafa","family":"Kamal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirna Mamdouh","family":"Shaker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Osama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nouran","family":"Hisham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,25]]},"reference":[{"issue":"4","key":"771_CR1","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1160\/TH07-03-0212","volume":"98","author":"AT Cohen","year":"2007","unstructured":"Cohen AT, Agnelli G, Anderson FA et al (2007) Venous thromboembolism (VTE) in Europe - The number of VTE events and associated morbidity and mortality. 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Eur Heart J 41(4):543\u2013603. https:\/\/doi.org\/10.1093\/EURHEARTJ\/EHZ405","journal-title":"Eur Heart J"},{"issue":"1061","key":"771_CR3","first-page":"70","volume":"111","author":"P Egermayer","year":"1988","unstructured":"Egermayer P, Town GI (1988) Compliance with guidelines for the investigation and management of patients with suspected pulmonary embolism at Christchurch Hospital. N Z Med J 111(1061): 70\u201373. https:\/\/pubmed.ncbi.nlm.nih.gov\/9549555\/. PubMed. Accessed 26 April 2025","journal-title":"N Z Med J"},{"issue":"5","key":"771_CR4","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1002\/jhm.421","volume":"4","author":"GJ Stashenko","year":"2009","unstructured":"Stashenko GJ, Hargett CW, Tapson VF (2009) Thrombolytic therapy for venous thromboembolism: current clinical practice. 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J Clin Experimental Investigations 6(1):10\u201315. https:\/\/doi.org\/10.5799\/AHINJS.01.2015.01.0478","journal-title":"J Clin Experimental Investigations"},{"issue":"9162","key":"771_CR7","doi-asserted-by":"publisher","first-page":"1386","DOI":"10.1016\/S0140-6736(98)07534-5","volume":"353","author":"SZ Goldhaber","year":"1999","unstructured":"Goldhaber SZ, Visani L, De Rosa M (1999) Acute pulmonary embolism: Clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet 353(9162):1386\u20131389. https:\/\/doi.org\/10.1016\/S0140-6736(98)07534-5","journal-title":"Lancet"},{"key":"771_CR8","unstructured":"The Promise of The PERT Consortium\u00ae PE Registry - Endovascular Today. Accessed April 26 (2025) https:\/\/evtoday.com\/articles\/2021-july-supplement\/the-promise-of-the-pert-consortiumpe-registry"},{"key":"771_CR9","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000008796","author":"S Jimenez","year":"2017","unstructured":"Jimenez S, Ruiz-Artacho P, Merlo M et al (2017) Risk profile, management, and outcomes of patients with venous thromboembolism attended in Spanish Emergency Departments the ESPHERIA registry. Published online. https:\/\/doi.org\/10.1097\/MD.0000000000008796","journal-title":"Published online"},{"issue":"7","key":"771_CR10","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1055\/S-0043-1764231\/ID\/JR03106-12\/BIB","volume":"49","author":"B Bikdeli","year":"2023","unstructured":"Bikdeli B, Muriel A, Wang Y et al (2023) Sex-Related Differences in Patient Characteristics, Risk Factors, and Symptomatology in Older Adults with Pulmonary Embolism: findings from the SERIOUS-PE Study. 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The approval number is MD-52-2023. A written consent was obtained from every participant, ensuring proper confidentiality and privacy.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"59"}}