YEARS Algorithm for Pulmonary Embolism (PE)
Helps rule out pulmonary embolism; also validated in pregnant patients with clinically suspected PE.
Use in hemodynamically stable patients ≥18 years old.
Take note of the following exclusion criteria:
- Treatment with therapeutic doses of anticoagulants initiated 24 hours or more before eligibility assessment.
- Life expectancy less than 3 months.
- Geographic inaccessibility precluding follow-up.
- Pregnancy (be sure to use pregnancy-adapted YEARS algorithm in the calc).
- Allergy to intravenous contrast agent.
Advice
- It's imperative to know if your institution reports D-dimer in FEU or DDU. This tool displays cutoffs for D-dimer reported as FEU.
- An approximate conversion that is often referenced is FEU = DDU * 2.
- PE was excluded (and CTPA deemed unnecessary) in patients who who fell below the D-dimer thresholds set by the YEARS algorithm.
- 3-month incidence of venous thromboembolism (VTE) of patients who did not undergo CTPA was 0.43%. This is similar to the traditional two-tier Wells' Score (0.34%).