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Maas AFG, Wyers C, Dielis A, Barten DG, van Kampen VEM, van der Krieken TE, de Kruif M, Simsek S, Spaetgens B, van Haaps T, Appelman B, Gritters NC, Doornbos S, Moeniralam HS, Noordzij PG, Reidinga A, Douma RA, Nossent EJ, Beudel M, Elbers P, Middeldorp S, van Es N, van den Bergh JPW, van Osch FHM. The Incidence of Pulmonary Embolism in Hospitalized Non-ICU Patients with COVID-19 during the First Wave: A Multicenter Retrospective Cohort Study in the Netherlands. J Vasc Res 2024:1-8. [PMID: 38631294 DOI: 10.1159/000538312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 03/05/2024] [Indexed: 04/19/2024] Open
Abstract
INTRODUCTION During the first COVID-19 outbreak in 2020 in the Netherlands, the incidence of pulmonary embolism (PE) appeared to be high in COVID-19 patients admitted to the intensive care unit (ICU). This study was performed to evaluate the incidence of PE during hospital stay in COVID-19 patients not admitted to the ICU. METHODS Data were retrospectively collected from 8 hospitals in the Netherlands. Patients admitted between February 27, 2020, and July 31, 2020, were included. Data extracted comprised clinical characteristics, medication use, first onset of COVID-19-related symptoms, admission date due to COVID-19, and date of PE diagnosis. Only polymerase chain reaction (PCR)-positive patients were included. All PEs were diagnosed with computed tomography pulmonary angiography (CTPA). RESULTS Data from 1,852 patients who were admitted to the hospital ward were collected. Forty patients (2.2%) were diagnosed with PE within 28 days following hospital admission. The median time to PE since admission was 4.5 days (IQR 0.0-9.0). In all 40 patients, PE was diagnosed within the first 2 weeks after hospital admission and for 22 (55%) patients within 2 weeks after onset of symptoms. Patient characteristics, pre-existing comorbidities, anticoagulant use, and laboratory parameters at admission were not related to the development of PE. CONCLUSION In this retrospective multicenter cohort study of 1,852 COVID-19 patients only admitted to the non-ICU wards, the incidence of CTPA-confirmed PE was 2.2% during the first 4 weeks after onset of symptoms and occurred exclusively within 2 weeks after hospital admission.
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Affiliation(s)
- Arno F G Maas
- VieCuri Medical Center, Department of Internal Medicine, Venlo, The Netherlands
| | - Caroline Wyers
- VieCuri Medical Center, Department of Internal Medicine, Venlo, The Netherlands
| | - Arne Dielis
- VieCuri Medical Center, Department of Internal Medicine, Venlo, The Netherlands
| | - Dennis G Barten
- VieCuri Medical Center, Department of Emergency Medicine, Venlo, The Netherlands
| | | | | | - Martijn de Kruif
- Zuyderland Hospital, Department of Pulmonology, Heerlen, The Netherlands
| | - Suat Simsek
- Northwest Clinics, Department of Internal Medicine, Alkmaar, The Netherlands
- Department of Internal Medicine/Endocrinology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Bart Spaetgens
- Department of Internal Medicine, Division of General Internal Medicine, Section Geriatric Medicine, Maastricht University Medical Center and Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
| | - Thijs van Haaps
- Amsterdam University Medical Center, Department of Vascular Medicine, Amsterdam, The Netherlands
| | - Brent Appelman
- Center for Experimental and Molecular Medicine, Amsterdam UMC Location University of Amsterdam, Department(s), Amsterdam, The Netherlands
| | - Niels C Gritters
- Treant Zorggroep, Department of Intensive Care, Emmen, The Netherlands
| | - Stefan Doornbos
- Treant Zorggroep, Department of Intensive Care, Emmen, The Netherlands
| | - Hazra S Moeniralam
- St Antonius Hospital, Department of Internal Medicine, Nieuwegein, The Netherlands
| | - Peter G Noordzij
- St Antonius Hospital, Department of Intensive Care, Nieuwegein, The Netherlands
| | - Auke Reidinga
- Department of Intensive Care, Martini Ziekenhuis, Groningen, The Netherlands
| | - Renée A Douma
- Flevo Hospital, Department of Internal Medicine, Almere, The Netherlands
| | - Esther J Nossent
- Department of Pulmonary Medicine, Free University Amsterdam, Cardiovascular Sciences Research Institute, Amsterdam, The Netherlands
| | - Martijn Beudel
- Department of Neurology, Amsterdam Neuroscience Institute, Amsterdam, The Netherlands
| | - Paul Elbers
- Department of Intensive Care Medicine, Laboratory for Critical Care Computational Intelligence, Amsterdam Institute for Infection and Immunity, Vrije Universiteit, Amsterdam, The Netherlands
| | - Saskia Middeldorp
- Department of Internal Medicine, Division of General Internal Medicine, Section Geriatric Medicine, Maastricht University Medical Center and Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
| | - Nick van Es
- Department of Internal Medicine, Division of General Internal Medicine, Section Geriatric Medicine, Maastricht University Medical Center and Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
| | - Joop P W van den Bergh
- VieCuri Medical Center, Department of Internal Medicine, Venlo, The Netherlands
- Maastricht University, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - Frits H M van Osch
- Maastricht University, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
- VieCuri Medical Center, Department of Clinical Epidemiology, Venlo, The Netherlands
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Peeters NHC, van der Kraats AM, van der Krieken TE, van Iersel D, Janssen ERC, Heerspink FOL. The validity of ultrasound and shear wave elastography to assess the quality of the rotator cuff. Eur Radiol 2024; 34:1971-1978. [PMID: 37646806 PMCID: PMC10873448 DOI: 10.1007/s00330-023-10037-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/12/2023] [Accepted: 06/17/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVES US with shear wave elastography (SWE) could reduce the burden and costs of the diagnostic process for patients with rotator cuff disorders. The aim of this study is to investigate the validity of US and SWE in preoperative assessment of fatty infiltration (FI) and muscle atrophy of the supraspinatus (SSP) and infraspinatus (ISP) muscles. METHODS Patients with a rotator cuff disorder and a recent shoulder CT or MRI scan were eligible to participate. Goutallier and Warner stages of the SSP and ISP muscle were measured on the scan, for assessment of FI and muscle atrophy, respectively. These findings were compared with shear wave velocities (SWVs) assessed on US. Visual assessment of FI on US was compared with the Goutallier stage. To quantify the amount of muscle atrophy, the occupation ratio between SSP fossa and muscle was measured on MRI and US. RESULTS Seventy-eight shoulders were included in the analysis. The correlation found between the occupation ratio on US and Warner and Goutallier stage and ratio on MRI ranged between r = - 0.550 to 0.589. The Goutallier stage of ISP and SSP muscle assessed on US showed a fair correlation with the Goutallier stage on a scan of r = 0.574 and r = 0.582, respectively. There was a poor correlation between the SWVs and scan results (r = - 0.116 to 0.07). CONCLUSION SWE is not a valid method to measure the amount of FI or muscle atrophy in the SSP muscle. Therefore, SWE is not a suitable alternative for MRI in standard preoperative diagnostics in rotator cuff pathologies. CLINICAL RELEVANCE STATEMENT Shear wave elastography should not be used in the diagnostics of rotator cuff pathologies. KEY POINTS • There is a fair correlation between the Goutallier stage of the supraspinatus and infraspinatus muscle assessed on MRI and CT and visual assessment of fatty infiltration achieved on US. • Shear wave elastography is not a valid tool for the determination of the amount of fatty infiltration or muscle atrophy. • Shear wave elastography should not be used as a cheaper and less burdensome alternative for diagnostics in rotator cuff pathologies.
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Affiliation(s)
- Nina H C Peeters
- Department of Radiology, VieCuri Medical Center, Venlo, The Netherlands
| | - Annick M van der Kraats
- Department of Orthopaedic Surgery, VieCuri Medical Center, Tegelseweg 210, 5912 BL, Venlo, The Netherlands
| | | | - Dave van Iersel
- Department of Radiology, VieCuri Medical Center, Venlo, The Netherlands
| | - Esther R C Janssen
- Department of Orthopaedic Surgery, VieCuri Medical Center, Tegelseweg 210, 5912 BL, Venlo, The Netherlands.
- Department of Orthopaedic Surgery, Maastricht University Medical Center+, Maastricht, The Netherlands.
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