Rates similar to adults presenting to the emergency department with symptoms
By Lori Solomon HealthDay Reporter
THURSDAY, May 22, 2025 (HealthDay News) — Pulmonary embolism (PE) is more common in children than previously thought, according to a study presented at the American Thoracic Society 2025 International Conference, held from May 16 to 21 in San Francisco.
Jeffrey A. Kline, M.D., from the Indiana University School of Medicine in Indianapolis, and colleagues prospectively studied PE diagnosis in children. The analysis included data from 3,663 children (aged 4 to 17 years) with signs and symptoms prompting a diagnostic evaluation for PE at 21 children’s emergency departments across the United States (2020 to 2024).
The researchers found that an adjudicated diagnosis of PE+ was made in 4.2 percent of children, with isolated PE in 2.1 percent, isolated deep vein thrombosis (DVT) in 1.1 percent, and PE and DVT in 1.0 percent. Compared with all children in the cohort (mean age, 14 years), those with a PE diagnosis had a mean age of 15 years. D-dimer (79.5 percent) was ordered most for diagnostic testing in the emergency department, followed by computed tomographic pulmonary angiography (CTPA, 34.6 percent), ventilation-perfusion (VQ lung scan, 0.3 percent), magnetic resonance vascular imaging (MRI, 0.7 percent), and venous ultrasound (9.8 percent). CTPA was positive for PE in 10.4 percent, VQ was positive in 16.7 percent, MRI was positive in 16.7 percent, and venous ultrasound was positive for DVT in 17.8 percent.
“The frequency of PE+ and DVT+ were both surprisingly high,” the authors write. “These results generally reflect testing patterns and imaging yield rates for PE reported in extant literature for adults with suspected PE in the emergency department and indicate that PE is more common in children than current literature would suggest.”
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