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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To determine the value of computed tomography &#40;CT&#41; angiography of the chest as a diagnostic test to exclude pulmonary embolism and to assess compliance with diagnostic protocols for thromboembolic disease&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">We retrospectively studied patients who underwent CT angiography of the chest because of suspected pulmonary embolism in 2004&#46; All the patients were followed for 3 months&#46; The percentage of patients diagnosed with a thromboembolic event based on an objective test during the follow-up period was determined&#46; We analyzed the percentage of patients with a negative CT angiogram on whom additional diagnostic tests &#40;ultrasound of the lower limbs and&#47;or ventilation-perfusion lung scintigraphy&#41; were performed&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">One hundred sixty-five patients underwent CT angiography of the chest because of suspected pulmonary embolism in 2004&#46; Four of the patients were excluded from the study because they were on chronic anticoagulation therapy and a further 2 were excluded because they had a life expectancy of under 3 months&#46; Of the remaining 159 patients&#44; 60 had CT angiograms that were interpreted as high probability for pulmonary embolism &#40;prevalence of 38&#37;&#41;&#46; Thirty-five of the 99 patients with a negative CT angiogram experienced an objectively confirmed thromboembolic event &#40;63&#37; sensitivity&#59; 95&#37; confidence interval&#44; 53&#37;&#8211;73&#37;&#41;&#46; Other diagnostic tests were not performed in 46&#37; of the cases&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">In our setting&#44; a negative single-detector helical CT angiogram was not sensitive enough to exclude the diagnosis of pulmonary embolism&#46; Furthermore&#44; compliance with internationally accepted diagnostic protocols was far from optimal&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Determinar el rendimiento de la angiotomograf&#237;a axial computarizada &#40;angio-TAC&#41; de t&#243;rax en el diagn&#243;stico de exclusi&#243;n de la tromboembolia pulmonar &#40;TEP&#41; y comprobar la observancia de los protocolos diagn&#243;sticos de enfermedad tromboemb&#243;lica&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Realizamos un estudio retrospectivo de los pacientes a quienes se realiz&#243; una angio-TAC de t&#243;rax por sospecha de TEP durante el a&#241;o 2004&#46; Se realiz&#243; un seguimiento de 3 meses en todos ellos&#46; Se determin&#243; el porcentaje de pacientes diagnosticados de un episodio tromboemb&#243;lico por un m&#233;todo objetivo durante el per&#237;odo de seguimiento&#46; Se analiz&#243; el porcentaje de pacientes con angio-TAC negativa a quienes se realiz&#243; alguna prueba diagn&#243;stica adicional &#40;ecograf&#237;a de miembros inferiores y&#47;o gammagraf&#237;a de ventilaci&#243;n-perfusi&#243;n pulmonar&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Durante el a&#241;o 2004 se realizaron 165 angio-TAC de t&#243;rax por sospecha de TEP&#46; Se excluy&#243; a 4 pacientes con indicaci&#243;n de anticoagulaci&#243;n cr&#243;nica y a otros 2 con pron&#243;stico de vida inferior a 3 meses&#46; De los 159 pacientes restantes&#44; en 60 la angio-TAC se interpret&#243; como de alta probabilidad para TEP &#40;prevalencia del 38&#37;&#41;&#46; Entre los 99 pacientes con angio-TAC negativa&#44; se produjo un episodio tromboemb&#243;lico objetivamente confirmado en 35 de ellos &#40;sensibilidad del 63&#37;&#59; intervalo de confianza del 95&#37;&#44; 53&#8211;73&#37;&#41;&#46; En el 46&#37; de los pacientes no se realiz&#243; ninguna prueba diagn&#243;stica adicional&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">En nuestro medio la angio-TAC helicoidal no multidetectora negativa es insuficiente para el diagn&#243;stico de exclusi&#243;n de la TEP&#46; La observancia de los protocolos diagn&#243;sticos internacionalmente aceptados dista de ser &#243;ptima&#46;</p>"
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Original Articles
Thromboembolic Events in Patients After a Negative Computed Tomography Pulmonary Angiogram: a Retrospective Study of 165 Patients
David Jiméneza,
Corresponding author
djc_69_98@yahoo.com

Correspondence: Dr. D. Jiménez. Servicio de Neumología. Hospital Ramón y Cajal. Departamento de Medicina. Universidad de Alcalá de Henares. Ctra. de Colmenar, km 9.100. 28034 Madrid. España
, Mónica Gómeza, Ruth Herreroa, Eladio Lapresaa, Gema Díazb, Luciano Lanzaraa, Carlos Escobarc, Agustina Vicented, Javier Gaudóa, Luis Máiza, Antonio Sueiroa
a Sección de Neumología, Hospital Ramón y Cajal, Madrid, Spain
b Servicio de Neumología, Hospital de la Zarzuela, Madrid, Spain
c Servicio de Cardiología, Hospital Ramón y Cajal, Madrid, Spain
d Servicio de Radiodiagnóstico, Hospital Ramón y Cajal, Madrid, Spain
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To determine the value of computed tomography &#40;CT&#41; angiography of the chest as a diagnostic test to exclude pulmonary embolism and to assess compliance with diagnostic protocols for thromboembolic disease&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">We retrospectively studied patients who underwent CT angiography of the chest because of suspected pulmonary embolism in 2004&#46; All the patients were followed for 3 months&#46; The percentage of patients diagnosed with a thromboembolic event based on an objective test during the follow-up period was determined&#46; We analyzed the percentage of patients with a negative CT angiogram on whom additional diagnostic tests &#40;ultrasound of the lower limbs and&#47;or ventilation-perfusion lung scintigraphy&#41; were performed&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">One hundred sixty-five patients underwent CT angiography of the chest because of suspected pulmonary embolism in 2004&#46; Four of the patients were excluded from the study because they were on chronic anticoagulation therapy and a further 2 were excluded because they had a life expectancy of under 3 months&#46; Of the remaining 159 patients&#44; 60 had CT angiograms that were interpreted as high probability for pulmonary embolism &#40;prevalence of 38&#37;&#41;&#46; Thirty-five of the 99 patients with a negative CT angiogram experienced an objectively confirmed thromboembolic event &#40;63&#37; sensitivity&#59; 95&#37; confidence interval&#44; 53&#37;&#8211;73&#37;&#41;&#46; Other diagnostic tests were not performed in 46&#37; of the cases&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">In our setting&#44; a negative single-detector helical CT angiogram was not sensitive enough to exclude the diagnosis of pulmonary embolism&#46; Furthermore&#44; compliance with internationally accepted diagnostic protocols was far from optimal&#46;</p>"
      ]
      "es" => array:1 [
        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Determinar el rendimiento de la angiotomograf&#237;a axial computarizada &#40;angio-TAC&#41; de t&#243;rax en el diagn&#243;stico de exclusi&#243;n de la tromboembolia pulmonar &#40;TEP&#41; y comprobar la observancia de los protocolos diagn&#243;sticos de enfermedad tromboemb&#243;lica&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Realizamos un estudio retrospectivo de los pacientes a quienes se realiz&#243; una angio-TAC de t&#243;rax por sospecha de TEP durante el a&#241;o 2004&#46; Se realiz&#243; un seguimiento de 3 meses en todos ellos&#46; Se determin&#243; el porcentaje de pacientes diagnosticados de un episodio tromboemb&#243;lico por un m&#233;todo objetivo durante el per&#237;odo de seguimiento&#46; Se analiz&#243; el porcentaje de pacientes con angio-TAC negativa a quienes se realiz&#243; alguna prueba diagn&#243;stica adicional &#40;ecograf&#237;a de miembros inferiores y&#47;o gammagraf&#237;a de ventilaci&#243;n-perfusi&#243;n pulmonar&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Durante el a&#241;o 2004 se realizaron 165 angio-TAC de t&#243;rax por sospecha de TEP&#46; Se excluy&#243; a 4 pacientes con indicaci&#243;n de anticoagulaci&#243;n cr&#243;nica y a otros 2 con pron&#243;stico de vida inferior a 3 meses&#46; De los 159 pacientes restantes&#44; en 60 la angio-TAC se interpret&#243; como de alta probabilidad para TEP &#40;prevalencia del 38&#37;&#41;&#46; Entre los 99 pacientes con angio-TAC negativa&#44; se produjo un episodio tromboemb&#243;lico objetivamente confirmado en 35 de ellos &#40;sensibilidad del 63&#37;&#59; intervalo de confianza del 95&#37;&#44; 53&#8211;73&#37;&#41;&#46; En el 46&#37; de los pacientes no se realiz&#243; ninguna prueba diagn&#243;stica adicional&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">En nuestro medio la angio-TAC helicoidal no multidetectora negativa es insuficiente para el diagn&#243;stico de exclusi&#243;n de la TEP&#46; La observancia de los protocolos diagn&#243;sticos internacionalmente aceptados dista de ser &#243;ptima&#46;</p>"
      ]
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