ORIGINAL ARTICLES   

International Angiology 1999 December;18(4):299-305

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

The Friday afternoon pulmonary angiogram: Temporal relationship between onset of symptoms and requests for angiography

Athanasoulis C. A., Athanasoulis M. A.

From the Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts * School of Public Health, University of California, Berkeley, California (USA

Background. To deter­mine if pul­mo­nary embo­lism symp­toms and pul­mo­nary angio­gra­phy have a pro­cliv­ity for a par­tic­u­lar day of the week, month or sea­son (Part I) and to ­assess the ­length of time elaps­ing ­between the appear­ance of symp­toms and ­requests for pul­mo­nary angio­gra­phy (Part II). Design: Prospective (in part) col­lec­tion of data and ret­ro­spec­tive ­review of clin­i­cal ­records. Setting: Large met­ro­pol­i­tan, uni­ver­sity affil­i­at­ed hos­pi­tal.
Methods. Part I: 2,969 con­sec­u­tive pul­mo­nary angio­grams per­formed over 17 years, were collected accord­ing to the day of the week, month and sea­son of their per­for­mance. Relevant rates were cal­cu­lat­ed. Part II: A study ­of the time interval between the onset of pul­mo­nary embo­lism symp­toms and ­requests for and performance of angio­gra­phy was con­duct­ed in 128 ­patients.
Results. Part l. In the ­course of 17 years, more pul­mo­nary angio­grams were per­formed on Fridays (mean 37.2, SE 1.8), than on any other day of the week (p <.001). No pro­cliv­ity for a par­tic­u­lar month or sea­son was ­observed. Part II. The mean time ­elapsed ­between the onset of symp­toms and ­requests for angio­gra­phy was 24 hours (range 0.2-162, SE 4.3) for inpa­tients, and 45 hours (range 3-358, SE 7.8) for out­pa­tients. The angio­gram was com­plet­ed urgent­ly, with­in two hours of the onset of symp­toms, only in 2.4%.
Conclusions. Pulmonary angio­gra­phy has a pro­cliv­ity for Fridays. Pulmonary embo­lism symp­toms and con­se­quent angio­grams do not favour a spe­cif­ic day, month or sea­son. In most cases the time elaps­ing ­between the onset of symp­toms and ­requests for angio­gra­phy is too long to be con­sis­tent with urgen­cy. The fre­quent Friday pul­mo­nary angio­gram ­reflects a ten­den­cy to “mop up” unfin­ished busi­ness prior to ­the week’s end.