obstetrics-gynaecology emergency respiratory

YEARS Algorithm for Pulmonary Embolism

Validated algorithm combining 3 clinical criteria with D-dimer threshold to safely exclude pulmonary embolism. Particularly validated in pregnancy (adapted YEARS). Reduces CT-PA use vs. Wells score.

Score interpretation

Apply YEARS Rules 0–2

Apply the YEARS algorithm interpretation logic

→ 0 YEARS criteria + D-dimer <1000 ng/mL → PE excluded (no imaging needed). ≥1 YEARS criterion + D-dimer <500 ng/mL → PE excluded. Any other combination → CT-PA required. In pregnancy: if 0 criteria + D-dimer <1000 → PE excluded; otherwise start with lower limb Doppler/V-Q scan to minimise fetal radiation; CT-PA if V-Q inconclusive.

CT-PA Required 3–5

YEARS criteria ≥2 or high D-dimer — PE not excluded

→ CT pulmonary angiography (CT-PA); in pregnancy, discuss V-Q scan vs CT-PA with radiology; anticoagulate if PE highly suspected while awaiting imaging (LMWH in pregnancy); involve haematology/obstetrics

Interpretation bands for the YEARS Algorithm. Apply clinical judgement and local guidance.

References

van der Pol LM et al. Pregnancy-Adapted YEARS Algorithm for Diagnosis of Suspected Pulmonary Embolism. N Engl J Med. 2019;380(12):1139–1149.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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