Current practices in the diagnosis of acute pulmonary embolism: a comprehensive analysis of adherence to contemporary practice guidelines.

ABSTRACT

INTRODUCTION: Acute pulmonary embolism (PE) poses significant diagnostic challenges with potentially fatal outcomes if not promptly identified and treated. Despite the availability of clinical guidelines, adherence to diagnostic strategies varies globally, impacting patient outcomes. OBJECTIVES: To investigate the current diagnostic practices for PE among Polish physicians and their adherence to the contemporary European Society of Cardiology (ESC) 2019 Guidelines. PATIENTS AND METHODS: In this cross-sectional study utilizing a web-based survey developed through a Delphi methodology, we included hospital-based physicians across various specialties in Poland. The survey was focused on diagnostic practices, risk stratification, and adherence to the ESC 2019 Guidelines for PE. RESULTS: The study found limited use of guideline-recommended clinical prediction rules, with a large reliance on D-dimer assessments and CT pulmonary angiography. Risk stratification practices varied, often based on individual experience rather than evidence-based strategies. The vast majority of physicians (80.5%) had never contacted a Pulmonary Embolism Response Team (PERT), but 88% stated that they would if it were available. Cardiologists were more likely to employ guideline-recommended methods compared to other specialties. CONCLUSIONS: There is a need for increased adherence to guideline-recommended diagnostic and risk stratification strategies of acute PE among physicians in Poland. Enhancing the availability of Pulmonary Embolism Response Teams (PERTs) and promoting guideline-directed practices could improve diagnostic accuracy and patient outcomes.