作者
Yonathan Freund, Anthony Chauvin, Sonia Jimenez, Anne-Laure Philippon, Sonja Curac, Florent Fémy, Judith Gorlicki, Tahar Chouihed, Hélène Goulet, Emmanuel Montassier, Margaux Dumont, Laura Lozano Polo, Pierrick Le Borgne, Mehdi Khellaf, Donia Bouzid, Pierre-Alexis Raynal, Nizar Abdessaied, Saïd Laribi, Jeremy Guenezan, Olivier Ganansia, Ben Bloom, Oscar Miró, Marine Cachanado, Tabassome Simon
发表日期
2021/12/7
期刊
Jama
卷号
326
期号
21
页码范围
2141-2149
出版商
American Medical Association
简介
Importance
Uncontrolled studies suggest that pulmonary embolism (PE) can be safely ruled out using the YEARS rule, a diagnostic strategy that uses varying D-dimer thresholds.
Objective
To prospectively validate the safety of a strategy that combines the YEARS rule with the pulmonary embolism rule-out criteria (PERC) rule and an age-adjusted D-dimer threshold.
Design, Settings, and Participants
A cluster-randomized, crossover, noninferiority trial in 18 emergency departments (EDs) in France and Spain. Patients (N = 1414) who had a low clinical risk of PE not excluded by the PERC rule or a subjective clinical intermediate risk of PE were included from October 2019 to June 2020, and followed up until October 2020.
Interventions
Each center was randomized for the sequence of intervention periods. In the intervention period (726 patients), PE was excluded without chest imaging in patients with no YEARS criteria …
学术搜索中的文章
Y Freund, A Chauvin, S Jimenez, AL Philippon… - Jama, 2021