OBJECTIVE
To identify risk factors predictive of pulmonary embolus (PE) timing after a traumatic injury.
METHODS
One hundred eight traumatic injury patients with a confirmed diagnosis of PE were classified as early PE (≤4 days, n = 54) or late PE (>4 days, n = 54). Independent predictors of early versus late PE were identified using multivariate logistic regression.
RESULTS
Half the PEs were diagnosed ≤4 days of injury. Only long bone fractures independently predicted early PE (odds ratio 2.8; 95% confidence interval, 1.1–7.1). Severe head injuries were associated with late PE (odds ratio 11.1; 95% confidence interval, 3.9–31). Established risk factors such as age did not affect timing.
CONCLUSIONS
Half the PEs were diagnosed ≤4 days after injury. The risk of early PE appeared highest in patients with long bone fractures, and the benefits of immediate prophylaxis may outweigh risks. Patients with severe head injuries appear to have later PE events. Prospective interventional trials in these injury populations are needed.
Background:High fasting plasma glucose (FPG) levels before fluorodeoxyglucose (FDG) administration for positron emission tomography/computed tomography (PET/CT) might affect the accuracy of 18-fluoro-deoxy-glucose-positron emission tomography-computed tomography (FDG-PET/CT) in diagnosis of pancreatic lesions. Current guidelines require FPG levels of < 200 mg/dL before FDG administration; however, the literature on the effect of FPG levels of < 200 mg/dL on the accuracy of FDG-PET/CT is scarce.Objectives:The aim of this study was to evaluate the effect of FPG levels of < 200 mg/dL on the accuracy of FDG-PET/CT in diagnosis of pancreatic lesions.Patients and Methods:In this retrospective study, 161 patients who had FDG-PET/CT for initial diagnosis of pancreatic lesions were included. Fasting plasma glucose levels before FDG administration were recorded. Accuracy of FDG-PET/CT in diagnosis of pancreatic lesions was compared between patients who were non diabetic (FPG < 126 mg/dL) and hyperglycemic (126 ≤ FPG < 200 mg/dL).Results:Thirty-four patients were hyperglycemic and 127 non diabetic. Sensitivity, specificity, positive predictive value and negative predictive value of FDG-PET/CT were 90%, 88%, 87% and 91% in non diabetic and 82%, 92%, 95% and 73% in hyperglycemic patients, respectively. Overall, the accuracy was higher in non diabetic than hyperglycemic patients (89% vs. 85%).Conclusions:Accuracy of FDG-PET/CT for primary diagnosis of pancreatic lesions is higher in patients with FPG levels < 126 mg/dL than in patients with FPG levels between 126 and 200 mg/dL.
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