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塔斯马尼亚紧急情况部门在调查疑似肺栓塞时如何'明智选择'
Lauren E Thurlow1, Pieter J Van Dam2, Sarah J Prior3
1Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia.
Healthcare (Basel, Switzerland)
|June 10, 2023
概括
塔斯马尼亚的急诊室经常过度使用计算机断层扫描肺血管图 (CTPA) 来诊断肺栓塞 (PE). 许多CTPA在没有临床实践指南 (CPG) 指示或D-二次体检测的情况下被订购,这表明需要改进基于证据的实践.
科学领域:
- 放射学 放射学是一门学科.
- 紧急医疗 紧急医疗
- 医疗保健服务研究 医疗服务研究
背景情况:
- 过度使用计算机断层扫描肺血管图 (CTPAs) 来诊断肺栓塞 (PE) 是一个持续的问题.
- 选择明智的澳大利亚建议CTPAs只有在临床实践指南 (CPGs) 显示的情况下.
研究的目的:
- 评估塔斯马尼亚地区紧急服务部门在CTPA下令方面遵守基于证据的做法.
- 为了确定CTPA是否按照验证的CPG订购.
主要方法:
- 在塔斯马尼亚公共急诊室接受CTPA的患者的回顾性医疗记录审查.
- 包括2018年8月至2019年12月期间四个地点的2758个CTPA的数据.
主要成果:
- 肺栓塞 (PE) 在12.4%的CTPA中得到证实.
- 52.1%的患者缺乏记录的CPG或扫描前的D-二分体测试.
- 只有11.8%的扫描记录了CPG,而43%的扫描使用了D-二极管.
结论:
- 塔斯马尼亚州的急救部门并不始终坚持PE调查的"明智选择"原则.
- 需要进一步的研究来了解CTPA订单实践低于最佳的原因.
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