{
  "abstract": "Introduction Pulmonary Embolism (PE) is the third most common cardiovascular disease after coronary artery disease (CAD) and stroke. Treatment delays in PE is associated with high morbidity and mortality and early identification and diagnosis is recommended. However, PE has no established diagnostic time standard, unlike CAD and stroke that have established evidence that rapid diagnosis within a specified time improves morbidity and mortality. The aim of this systematic review is to determine how the time to diagnosis of a suspected PE impacts patient mortality.Methods A search was performed on Embase, Medline and Web of Science. The search was constructed to identify time to diagnosis of a suspected PE from symptom onset, or hospital presentation. The primary outcome was mortality. Quality assessment was performed using the Critical Appraisal Skills Programme (CASP) for cohort studies. A narrative synthesis was used to report findings.Results A total of 11 studies are included after screening of the identified records (n=9 885). Two diagnostic time intervals associated with mortality are identified. The first, defined by symptom onset to diagnosis (SDx), is subjectively measured. The second, defined by presentation (door) to diagnosis (DDx), is objectively measured. Most studies that report a SDx delay demonstrate no impact on mortality. Conversely, all studies that report a DDx delay demonstrate a negative impact on patient mortality. A DDx time (<5 hours) in intermediate to high-risk PE improves mortality. Furthermore, faster DDx times lead to early treatment and sustained mortality reduction in patients. All included studies are cohort studies with heterogeneity and increased risk of bias.Conclusion A delay from patient presentation to diagnosis of PE demonstrate a negative impact on mortality. A diagnosis made within 5 hours in intermediate to high-risk PE may improve mortality. Future robust and high-quality research is needed to confirm these findings and determine the true impact of rapid diagnosis on mortality. *presenting author",
  "authors": [
    {
      "affiliations": [
        "University Hospital Limerick",
        "University of Manchester"
      ],
      "name": "Gideon-Phil Meyer"
    },
    {
      "affiliations": [
        "University Hospital Limerick",
        "University of Manchester"
      ],
      "name": "Lizeri Jansen"
    }
  ],
  "title": "#227 A systematic review on how the time to diagnosis of suspected Pulmonary Emboli impacts patient mortality",
  "uid": "39cbfb4e-3984-568b-a996-d8a81a413483"
}