Kanako Kunishima Kumamaru MD, Presenter: Nothing to Disclose

Andetta Rotilla Hunsaker MD, Abstract Co-Author: Nothing to Disclose

Arash Bedayat MD, Abstract Co-Author: Nothing to Disclose

Jason Signorelli, Abstract Co-Author: Nothing to Disclose

Hiraku Kumamaru, Abstract Co-Author: Nothing to Disclose

Frank John Rybicki MD, PhD, Abstract Co-Author: Research grant, Toshiba Corporation Research grant, Bracco Group

To test the hypothesis that earlier communication of CT findings from radiologists to clinicians is associated with better outcomes for patients with acute pulmonary embolism (PE).

Of 1427 CT pulmonary angiography (CTPA) studies with acute PE performed from 2006/02 to 2010/03, 450 consecutive patients with CTPA performed between Monday and Friday, and who were hospitalized with “primary” diagnosis of acute PE, were retrospectively enrolled. The time from CTPA to the following three communications from radiologists to clinicians were measured: 1) face-to-face or telephone notice of acute PE, 2) signing of CT report, and 3) separate, email notification of the right ventricle (RV) enlargement, size based on the right-to-left ventricular (RV/LV) diameter ratio. Multiple linear or logistic regression analyses assessed the association of these three parameters, all dichotomized into binary explanatory variables, with patient mortality and log-transformed Length of hospital Stay (LoS), while controlling for other related factors.

Delayed face-to-face or telephone notification of acute PE (> 60 minutes) and the delayed signing of CT report (> 24 hours) were both independently associated with higher 30-day mortality (adjusted odds ratios: 4.44 (95%CI:1.78-11.0) and 3.17 (95%CI:1.08-9.36), respectively). Early email notice of RV/LV diameter ratio (<= 24 hours) was associated with approximately 25% decrease in the average LoS (p=0.015). Other factors related to outcomes included CT examination time, location of PE (central, lobar, segment, or sub-segment), presence of RV enlargement, age, and presence of co-morbidities.

Earlier communication from radiologists to clinicians regarding PE diagnosis and the RV/LV diameter ratio observed on CT images is associated with better outcomes for patients with acute PE.

Radiologists are recommended to make sooner notifications of acute PE and the presence of RV enlargement. This could have a contribution to better health and health service outcomes.

Kumamaru, K, Hunsaker, A, Bedayat, A, Signorelli, J, Kumamaru, H, Rybicki, F, Earlier Communication of CT Findings from Radiologists to Clinicians Is Associated with Better Outcomes for Patients with Acute Pulmonary Embolism.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11005256.html