Maryam Razavi

maryam.razavi@cambio.se

@CambioCDS

To help rule out pulmonary embolism in suspected PE.

Use in hemodynamically stable patients ≥18 years old with clinically suspected acute pulmonary embolism (PE). YEARS items (Yes=1, No=0): Clinical signs of DVT, Hemoptysis, PE most likely diagnosis. Other items: - Pregnant patient: Yes, No - Compression ultrasonography of symptomatic leg: Yes, No - D-dimer ≥500 ng/mL: Yes, No - D-dimer ≥1,000 ng/mL: Yes, No Interpretation is based on decision tree Van der Pol 2019: - Initiate anticoagulant, Pregnancy-adapted YEARS algorithm recommends initiation of anticoagulant treatment. - PE excluded, YEARS algorithm rules out PE (0.43% with symptomatic VTE during 3-month follow-up). - PE not excluded, YEARS algorithm recommends CTPA.

Not to be used in patients younger than 18 years old or patients with hemodynamic instability.

1. Van der Hulle T, Cheung WY, Kooij S, et al. Simplified diagnostic management of suspected pulmonary embolism (the YEARS study): a prospective, multicentre, cohort study. Lancet. 2017. 2. Kabrhel C, Van hylckama vlieg A, Muzikanski A, et al. Multicenter Evaluation of the YEARS Criteria in Emergency Department Patients Evaluated for Pulmonary Embolism. Acad Emerg Med. 2018;25(9):987-994. 3. Van der pol LM, Tromeur C, Bistervels IM, et al. Pregnancy-Adapted YEARS Algorithm for Diagnosis of Suspected Pulmonary Embolism. N Engl J Med. 2019;380(12):1139-1149. 4. Van der Pol LM, Van der Hulle T, Cheung YW, et al. No added value of the age-adjusted D-dimer cut-off to the YEARS algorithm in patients with suspected pulmonary embolism. J Thromb Haemost. 2017;15(12):2317-2324. 5. Righini M, Van es J, Den exter PL, et al. Age-adjusted D-dimer cutoff levels to rule out pulmonary embolism: the ADJUST-PE study. JAMA. 2014;311(11):1117-24.

OBSERVATION.years_algorithm_for_pulmonary_embolism_pe.v0, OBSERVATION.lab_test-coagulation_profile.v1