The Friday afternoon pulmonary angiogram: temporal relationship between onset of symptoms and requests for...

To determine if pulmonary embolism symptoms and pulmonary angiography have a proclivity for a particular day of the week, month or season (Part I) and to assess the length of time elapsing between the appearance of symptoms and requests for pulmonary angiography (Part II).

Prospective (in part) collection of data and retrospective review of clinical records.

Large metropolitan, university affiliated hospital.

Part I: 2,969 consecutive pulmonary angiograms performed over 17 years, were collected according to the day of the week, month and season of their performance. Relevant rates were calculated. Part II: A study of the time interval between the onset of pulmonary embolism symptoms and requests for and performance of angiography was conducted in 128 patients. Results. Part 1. In the course of 17 years, more pulmonary angiograms were performed on Fridays (mean 37.2, SE 1.8), than on any other day of the week (p <.001). No proclivity for a particular month or season was observed. Part II. The mean time elapsed between the onset of symptoms and requests for angiography was 24 hours (range 0.2-162, SE 4.3) for inpatients, and 45 hours (range 3-358, SE 7.8) for outpatients. The angiogram was completed urgently, within two hours of the onset of symptoms, only in 2.4%.

Pulmonary angiography has a proclivity for Fridays. Pulmonary embolism symptoms and consequent angiograms do not favour a specific day, month or season. In most cases the time elapsing between the onset of symptoms and requests for angiography is too long to be consistent with urgency. The frequent Friday pulmonary angiogram reflects a tendency to "mop up" unfinished business prior to the week's end.