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J Thromb Thrombolysis. 2019 Apr;47(3):436-443. doi: 10.1007/s11239-018-1788-x.

Awareness and management of pulmonary embolism among physicians in China: a nationwide cross-sectional study.

Zhang M1,2,3,4, Zhang YX5,2,3,4, Zhang Z2,3,4,6, Wang J1,2,3,4, Shao X2,3,4,7, Xie WM5,2,3,4, Wan J5,2,3,4, Zhai ZG8,9,10,11, Wang C12,13,14,15,16.

Author information

1
Peking University Health Science Center, 38 Xueyuan Rd, Haidian District, Beijing, 100191, China.
2
Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Hepingli, Chaoyang District, Beijing, 100029, China.
3
Center for Respiratory Diseases, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Hepingli, Chaoyang District, Beijing, 100029, China.
4
National Clinical Research Center for Respiratory Diseases, 2 Yinghua Dongjie, Hepingli, Chaoyang District, Beijing, 100029, China.
5
Department of Respiratory Disease, Capital Medical University, 2 Yinghua Dongjie, Hepingli, Chaoyang District, Beijing, 100029, China.
6
Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, 100730, China.
7
Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China.
8
Department of Respiratory Disease, Capital Medical University, 2 Yinghua Dongjie, Hepingli, Chaoyang District, Beijing, 100029, China. zhaizhenguo2011@126.com.
9
Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Hepingli, Chaoyang District, Beijing, 100029, China. zhaizhenguo2011@126.com.
10
Center for Respiratory Diseases, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Hepingli, Chaoyang District, Beijing, 100029, China. zhaizhenguo2011@126.com.
11
National Clinical Research Center for Respiratory Diseases, 2 Yinghua Dongjie, Hepingli, Chaoyang District, Beijing, 100029, China. zhaizhenguo2011@126.com.
12
Department of Respiratory Disease, Capital Medical University, 2 Yinghua Dongjie, Hepingli, Chaoyang District, Beijing, 100029, China. cyh-birm@263.net.
13
Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Hepingli, Chaoyang District, Beijing, 100029, China. cyh-birm@263.net.
14
Center for Respiratory Diseases, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Hepingli, Chaoyang District, Beijing, 100029, China. cyh-birm@263.net.
15
National Clinical Research Center for Respiratory Diseases, 2 Yinghua Dongjie, Hepingli, Chaoyang District, Beijing, 100029, China. cyh-birm@263.net.
16
Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, 100730, China. cyh-birm@263.net.

Abstract

Pulmonary embolism (PE) is a leading cause of cardiovascular mortality. We intended to evaluate the awareness and management status of PE among Chinese physicians and provide the basis for establishing Chinese clinical guidelines on PE. We designed a nationwide survey to collect data on physicians' awareness of diagnosis, treatment and follow-up on PE. The questionnaires were distributed to physicians during offline academic meetings and by the online platforms from August 2016 to October 2016. Also, results were sub-grouped by age, hospital grades, departments and trained or not. A total of 2954 valid questionnaires were collected. We observed that there were several defects in the management of PE among Chinese physicians. First, a considerable proportion of physicians chose the incorrect clinical prediction rules for acute PE. Second, a considerable percentage of hospitals could not carry out computed tomographic pulmonary angiography (22.4%) or ventilation-perfusion scintigraphy (65.2%). Third, only a few physicians knew the use of new oral anticoagulants clearly (33.4%). Fourth, only 49% of physicians achieved follow-up management in over half of their patients. Additionally, physicians in the tertiary hospitals, aged > 35 years, trained and from respiratory department have a better knowledge of the management of PE. In conclusion, our survey demonstrates the enhancement of PE-related trainings, especially for physicians in lower-level hospitals, aged ≤ 35 years and from non-respiratory department, can help to improve the management of PE in Chinese physicians. And our study also highlights the need for the establishment of national guidelines for the management of PE in China.

KEYWORDS:

Awareness; Management; Pulmonary embolism

PMID:
30612330
DOI:
10.1007/s11239-018-1788-x

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