|ECR 2018 / C-0629|
|Are we over imaging the obese patient with suspected pulmonary embolus?|
Aims and objectives
Venous thromboembolism is a significant cause of morbidity and mortality globally and has a multifactorial aetiology, that usually involves two or more risk factors. Obesity is also a significant global health issue and a known risk factor for VTE . Many signs and symptoms of pulmonary embolus such as tachycardia, shortness of breath and hypoxaemia can be found at baseline in obese patients. Morbidly obese patients demonstrate ECG changes such as low voltage, T wave flattening and axis changes, and even D dimers can elevated at baseline. . As a result of this, there is a risk that patients classified as obese are scanned unnecessarily more.
CT pulmonary angiogram is the gold standard for diagnosis of pulmonary embolism, and is one of the most common studies ordered in a radiology department. However, its dose is not insignificant, especially in women where the breast dose can be up to 70mGy . Obese patients, in particular, are subject to an even higher dose again, as often tube current and voltage are increased in these patients to reduce image noise .
Our study aimed to audit the amount of CTPAs being performed in our department over a one year period, and determine if there was a significant difference in the number of positive studies for pulmonary embolism between obese and non obese patients in the age category 18-50.
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