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Approaches of Physicians for the Diagnosis and Treatment of Pulmonary Thromboembolism: A Questionnaire Study [Eurasian J Pulmonol]
Eurasian J Pulmonol. 2016; 18(2): 96-103 | DOI: 10.5152/ejp.2016.40085  

Approaches of Physicians for the Diagnosis and Treatment of Pulmonary Thromboembolism: A Questionnaire Study

Ceyda Anar1, Oğuzhan Okutan2, Bülent Altınsoy3, Savaş Özsu4, Oğuz Uzun5
1Clinic Of Chest Diseases, Dr. Suat Seren Chest Diseases And Thoracic Surgery Training And Research Hospital, Izmir
2Clinic Of Chest Diseases, Gülhane Military Medical Academy Haydarpaşa Training Hospital, Istanbul
3Department Of Chest Diseases, Bülent Ecevit University Faculty Of Medicine, Zonguldak
4Department Of Chest Diseases, Karadeniz Technical University Faculty Of Medicine, Trabzon
5Department Of Chest Diseases, Ondokuz Mayıs University Faculty Of Medicine, Samsun

Objective: We aimed to demonstrate the approaches of physicians with a questionnaire toward the patients with pulmonary thromboembolism (PTE) in our country.
Methods: An invitation letter including a questionnaire with 28 questions to assess the approaches they prefer in the patients with PTE and the capabilities of the departments they work at and a link for the questionnaire was directed to the mail groups of chest diseases specialists. Responses of the physicians who participated in the questionnaire were reviewed.
Results: The examinations used to diagnose PTE such as D-dimer, troponin, echocardiographic Doppler ultrasonography and multidetector computed tomography (CT) have been performed in 94% of the institutions, ventilation/perfusion scintigraphy, MRI and pulmonary angiography examinations were performed in 50% of the instututions. While D-dimer test was performed in 73.2% of the institutions by quantitative ELISA; in 15.7% of them it was semiquantitative and in 11.6% of the instutitions it was performed by latex agglutination. 81% of physicians were seen to be using clinical probability scoring systems and most commonly used scoring method was seen to be Wells scoring with a rate of 90%. According to the simplified PESI score, 61.5% of the physicians reported to prefer outpatient treatment. In non-massive and submassive pulmonary thromboemboli patients, 86.2% of the physicians reported to prefer thr low molecular weight heparin (LMWH) treatment; vitamin K antagonist in maintenance treatment was also the most commonly resorted drug with a percentage of 84.9.
Conclusion: The absence of the examinations used in the diagnosis and treatment of PTE in most institutions and difficulty to reach the available examinations at all hours of the day were significant facts. Especially; lack of access to high-sensitivity D-dimer test, bedside echocardiography used to assess right ventricular dysfunction, troponin and NT-proBNP makes us think about low adaptation to guidelines.

Keywords: Pulmonary embolism, diagnosis, treatment, D-dimer

Ceyda Anar, Oğuzhan Okutan, Bülent Altınsoy, Savaş Özsu, Oğuz Uzun. Approaches of Physicians for the Diagnosis and Treatment of Pulmonary Thromboembolism: A Questionnaire Study. Eurasian J Pulmonol. 2016; 18(2): 96-103

Corresponding Author: Ceyda Anar, Türkiye

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