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
No YEARS item and D-dimer < 1000 ng/mL, or ≥ 1 item and D-dimer < 500 ng/mL.
→ No imaging for PE; consider alternative diagnoses. The same thresholds were validated in pregnancy (Artemis, van der Pol 2019).
D-dimer at or above the threshold for the number of YEARS items — PE not excluded.
→ CT pulmonary angiography. In pregnancy with signs of DVT, compression ultrasound first; if it shows DVT, treat without CTPA. Give therapeutic LMWH while awaiting imaging unless contraindicated.
Interpretation bands for the YEARS Algorithm. Apply clinical judgement and local guidance.
References
- van der Hulle T, et al. Simplified diagnostic management of suspected pulmonary embolism (the YEARS study): a prospective, multicentre, cohort study. Lancet. 2017;390(10091):289–297.
- 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.
Related
Curated clinical cross-links plus same-class fallbacks.
- Composite Pulmonary Embolism Shock (CPES) Score · Pulmonary Embolism
- Pulmonary Embolism Severity Index (PESI) · Pulmonary Embolism
- Wells' Criteria for Pulmonary Embolism · Pulmonary Embolism
- Revised Geneva Score for Pulmonary Embolism · Pulmonary Embolism
- Bova Score for Pulmonary Embolism Complications · Pulmonary Embolism
- Pulmonary Embolism Severity Index (PESI) -- Full Version · Pulmonary Embolism
- Nitric Oxide (Inhaled — iNO) · Selective Pulmonary Vasodilator
- Selexipag · Pulmonary Arterial Hypertension
- Macitentan · Pulmonary Arterial Hypertension
- Methotrexate (Ectopic) · Antimetabolite (Ectopic Pregnancy Management)
- Hydralazine (IV — Acute Hypertension in Pregnancy) · Vasodilator (Antihypertensive)
- Methyldopa (Chronic Hypertension in Pregnancy) · Centrally Acting Antihypertensive
- Paracetamol overdose · TOXBASE/NPIS; MHRA DSU 2012/2024; SNAP regimen (Lancet 2014)
- TCA overdose · TOXBASE/NPIS; AACT/EAPCCT position statements; Resuscitation Council UK ALS
- Opioid overdose · TOXBASE/NPIS; Resuscitation Council UK
- Anticholinergic toxidrome · TOXBASE/NPIS; AACT/EAPCCT
- Benzodiazepine overdose · TOXBASE/NPIS; AACT/EAPCCT
- β-blocker overdose · TOXBASE/NPIS; AACT/EAPCCT; ESC
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.