February 14, 2022
Sam Ashoo, MD, FACEP TR Eckler, MD, FACEP (Peer Review)
PE is suspected.
Is the patient pregnant?
The YEARS algorithm was developed to reduce the use of CT Pulmonary Angiography (CTPA) in adults. It was found to reduce CTPA use by 14% compared to standard evaluation, and by 8.7% compared to age adjusted d-dimer testing.
The cut-off for D-dimer testing in the YEARS algorithm depends on your response to the questions in this pathway. The pathways begins with suspicion of PE. If you do not have a suspicion for PE, do not proceed.
This pathway is based on the publications below. It is not based on an EB Medicine article.
- van der Hulle T, Cheung WY, et al. YEARS study group. Simplified diagnostic management of suspected pulmonary embolism (the YEARS study): a prospective, multicentre, cohort study. Lancet. 2017 Jul 15;390(10091):289-297. PubMed
- van der Pol LM, van der Hulle T, et al. No added value of the age-adjusted D-dimer cut-off to the YEARS algorithm in patients with suspected pulmonary embolism. J Thromb Haemost. 2017 Dec;15(12):2317-2324. Full Text
- Kabrhel C, Van Hylckama Vlieg A, et al. Multicenter Evaluation of the YEARS Criteria in Emergency Department Patients Evaluated for Pulmonary Embolism. Acad Emerg Med. 2018 Sep;25(9):987-994. Full Text
- van der Pol LM, Tromeur C, et al. Pregnancy-Adapted YEARS Algorithm for Diagnosis of Suspected Pulmonary Embolism. N Engl J Med. 2019 Mar 21;380(12):1139-1149. Full Text
- Bates S, Rajasekhar A, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: venous thromboembolism in the context of pregnancy. Blood Adv 2018; 2 (22): 3317–3359. Full Text
Full Pregnancy Adapted YEARS Pathway