Key result
The incidence of pulmonary embolism on CT pulmonary angiography did not significantly differ between younger and older patients across multiple age cutoffs (e.g., P=0.7220 for age 40 cutoff).
Why the study?
Does the incidence of pulmonary embolism on CTPA differ between younger and older patients with suspected acute PE?
Observational (n=631)
Does the incidence of pulmonary embolism on CTPA differ between younger and older patients with suspected acute PE?
p-value: p=0.7220
The incidence of pulmonary embolism on CTPA does not significantly differ between younger and older patients, suggesting no age-related bias for overutilization in younger patients.
Supports equivalent PE yield on CTPA across ages; leaves open prospective validation of age-specific imaging thresholds.
OBJECTIVE: The aim of this study is to compare the incidence of pulmonary embolism (PE) on computed tomography (CT) studies between younger and older patients to determine if there is an age-related bias for overutilization of CT pulmonary angiography (CTPA) in younger patients. MATERIAL AND METHODS: Six hundred thirty-one consecutive CTPA cases for suspected acute PE between 11/10/2003 and 3/19/2004 were retrospectively studied. Of these 631 cases, 59 patients were found to have clots in the pulmonary arteries (ranging from central to subsegmental PA). CTPA was performed using multidetector CT at 1.25-mm collimation, 120 kVp, 320 mA. Patients were categorized by gender and age: A, less than 20 (n = 11); B, 20 to 29 (n = 44); C, 30 to 39 (n = 59); D, 40 to 49 (n = 90); E, 50 to 59 (n = 120); F, 60 to 69 (n = 114); G, 70 to 79 (n = 104); H, 80 to 89 (n = 72); I, 90 or more (n = 21). The incidences of PE were calculated in each gender and age group. To compare the incidence of PE between younger and older groups, they were divided into 2 groups at the ages of 40 (<39 and > or = 40), 50 (<49 and > or = 50), and 60 (<59 and > or = 60). Statistical analysis was performed using the chi test. RESULTS: The incidences of PE were 11.9% in males (A, 0%; B, 17.6%; C, 10%; D, 8.3%; E, 13.3%; F, 6.9%; G, 17.5%; H, 23.5%; I, 0%), 7.7% in females (A, 0%; B, 7.4%; C, 5.1%; D, 12.5%; E, 4.2%; F, 14.5%; G, 7.8%; H, 5.5%; I, 0%), and 9.4% in total patients (A, 0%; B, 11.1%; C, 6.8%; D, 11.1%; E, 7.5%; F, 10.5%; G, 11.5%; H, 9.7%; I, 0%). No significant differences in the incidences of PE were observed when patients were divided at the age of 40 (male, female, total; P=1.0, 0.6252, 0.7220), at the age of 50 (male, female, total; P = 0.6748, 0.6879, 1.0), or at the age of 60 (male, female, total; P = 0.8458, 0.7046, 0.6820). CONCLUSION: No statistically significant difference in the incidence of PE was observed between younger and older patients. Our findings suggest that there is no age-related bias for overutilization of CT angiography (CTA) in younger patients.
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Kuroki et al. (2006) conducted an observational in Suspected acute pulmonary embolism (n=631). Younger age vs. Older age was evaluated on Incidence of pulmonary embolism on CT pulmonary angiography (p=0.7220). The incidence of pulmonary embolism on CT pulmonary angiography did not significantly differ between younger and older patients across multiple age cutoffs (e.g., P=0.7220 for age 40 cutoff).
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