Return emergency department visits for recurrent pulmonary embolism symptoms in children and adolescents

Area of Science:

• Pediatric Medicine
• Cardiology
• Radiology

Background:

• Pediatric pulmonary embolism (PE) rates have risen significantly over 20 years.
• Outcomes post-hospitalization for pediatric PE are not well-understood.
• Many children experience persistent symptoms like chest pain or dyspnea after PE diagnosis.

Purpose of the Study:

• To assess emergency department (ED) return rates for PE-related symptoms in children.
• To evaluate the diagnostic utility of repeat computed tomography angiography (CTA) in pediatric PE patients.
• To identify risk factors for ED return visits and PE recurrence.

Main Methods:

• Retrospective cohort study of 96 pediatric patients diagnosed with PE.
• Analysis of return visits to the ED for PE-related symptoms.
• Review of repeat computed tomography angiography (CTA) utilization and outcomes.

Main Results:

• 42% of patients returned to the ED for PE-related symptoms, with a median return time of 34 days.
• Repeat CTAs were frequently performed (74 total), averaging 1.8 per returning patient.
• Increased age and female sex were identified as risk factors for ED return visits; PE recurrence was 8% and linked to thrombotic risk factors.

Conclusions:

• Pediatric PE patients frequently return to the ED for related symptoms, often necessitating repeat imaging.
• Risk factors for return visits include older age and female sex.
• Developing risk stratification for PE recurrence can help optimize follow-up care and reduce unnecessary imaging.