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Meta-Analysis
. 2024 Aug;31(4):567-580.
doi: 10.1007/s10140-024-02249-7. Epub 2024 Jun 7.

Computed tomography pulmonary angiography (CTPA) for the detection of pulmonary embolism (PE) among trauma patients: a systematic review and meta-analysis

Shirin Yaghoobpoor #  1   2 , Mobina Fathi #  1   2 , Hayder Jasim Taher  3 , Afraa Jasim Farhood  4 , Ashkan Bahrami  5 , Reza Eshraghi  5 , Ramtin Hajibeygi  1 , Zohreh Tutunchian  2 , Lee Myers  6 , Rojin Ahmadi  7 , Ali Gholamrezanezhad  8
Affiliations
Meta-Analysis

Computed tomography pulmonary angiography (CTPA) for the detection of pulmonary embolism (PE) among trauma patients: a systematic review and meta-analysis

Shirin Yaghoobpoor et al. Emerg Radiol. 2024 Aug.

Abstract

Background and objectives: Computed tomography pulmonary angiography (CTPA) is a standard imaging technique employed for the detection of pulmonary embolism (PE). This systematic review and meta-analysis aims to examine the prevalence of PE among the trauma patients undergoing CTPA.

Methods: A comprehensive search across PubMed, Scopus, Google Scholar, and Web of Science yielded 13 studies encompassing 5,570 individuals conducted following Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guideline. Studies that used CTPA for the detection of PE among the trauma patients were selected. This resulted in an evaluation of prevalence, trauma types, clinical manifestations, radiological findings, and mortality rates of PE among traumatic patients undergoing CTPA.

Results: The overall prevalence of PE among trauma patients undergoing CTPA was 18% (95% CI = 13-24%). After pooling the existing data, femur fractures were determined to be the most prevalent trauma type (12%). The most prevalent clinical manifestations of PE among trauma patients included shortness of breath, chest pain, and altered vital signs. Radiological findings encompassed various pulmonary abnormalities, such as opacity, ground-glass opacities, and pleural effusions. Mortality rates of PE among the trauma patients ranged from 0% to 29.4% across the included studies.

Conclusion: This study provides comprehensive insights into the prevalence, clinical manifestations, radiological findings and mortality of PE among trauma patients undergoing CTPA. According to our findings, lower threshold for CTPA is recommended in patients with lower extremity or spine fractures.

Keywords: Computed tomography pulmonary angiography; Meta-analysis; Prevalence; Pulmonary embolism; Systematic review; Trauma patients.

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Conflict of interest statement

All authors confirm they have no competing interests.

Figures

Fig. 1
Fig. 1
The Begg’s test diagram showing the publication bias among the included studies
Fig. 2
Fig. 2
Study flow diagram
Fig. 3
Fig. 3
The forest plot indicating the pooled prevalence of PE among trauma patients undergone CTPA. The weight of each paper on the meta-analysis is indicated by each parallelogram, the 95% CI is visualized by the interval within the boundaries. Literature is presented based on random effect model.
See this image and copyright information in PMC

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