Computed Tomographic Pulmonary Angiography Might Overdiagnose Pulmonary Embolism

Incidence of PE rose dramatically after CTPA was introduced, but PE mortality did not decrease concomitantly.

Computed tomographic pulmonary angiography (CTPA) was introduced in 1998 and rapidly replaced other tests (such as ventilation/perfusion scans); its use increased roughly 10-fold from 1998 to 2006. CTPA is more sensitive than older tests for diagnosing pulmonary embolism (PE). Whether its use has led to “overdiagnosis” (defined as detection of clinically insignificant PE) was assessed indirectly with a time analysis of PE incidence and mortality from 1993 through 2006 in a U.S. national inpatient database.

From 1993 to 1998, the age-adjusted incidence of PE showed no significant change (about 60 cases/100,000 adults), but incidence increased by 81% from 1998 to 2006 (to 112 cases/100,000 adults). Age-adjusted PE mortality decreased more from…

Reviewing Author

Thomas L. Schwenk, MD

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Thomas L. Schwenk, MD

Disclosures

Editorial BoardsUpToDate