YEARS Algorithm for PE Diagnosis
Stepwise algorithm combining 3 clinical items with D-dimer to exclude PE. Uses lower D-dimer threshold (500 μg/L) when ≥1 YEARS item present, higher threshold (1000 μg/L) when no YEARS items.
Score interpretation
0 YEARS criteria AND D-dimer < 1000 μg/L, OR ≥1 YEARS criteria AND D-dimer < 500 μg/L: PE safely excluded.
→ No further imaging for PE required. Consider alternative diagnoses.
D-dimer exceeds the applicable threshold for the clinical probability. PE not excluded.
→ Proceed to CTPA. Anticoagulate if high clinical suspicion and imaging delayed > 4h.
≥1 YEARS criteria AND D-dimer ≥ 1000 μg/L. High concern for PE.
→ Urgent CTPA. Empirical anticoagulation if any significant delay. Senior review.
Interpretation bands for the YEARS. 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.
Related
Curated clinical cross-links plus same-class fallbacks.
- Nitric Oxide (Inhaled — iNO) · Selective Pulmonary Vasodilator
- Selexipag · Pulmonary Arterial Hypertension
- Macitentan · Pulmonary Arterial Hypertension
- Fluorescein Sodium 2% Eye Drops · Diagnostic ophthalmic dye
- Indocyanine Green (Intravitreal Chromovitrectomy) · Diagnostic Dye — Vitreoretinal Surgery / ICG Angiography
- Lissamine Green 1% Eye Drops · Vital Dye — Ocular Surface Staining (Dry Eye Diagnosis)
- Acute Asthma in Adults · BTS/SIGN British Guideline on Asthma 2019; NICE NG80
- Pulmonary Embolism Assessment · NICE NG158; ESC 2019 PE Guidelines
- Acute Exacerbation of COPD (AECOPD) · NICE NG115; GOLD 2024
- Spontaneous Pneumothorax (Adult) · BTS Pleural Disease 2023
- Atypical Pneumonia (Legionella / Mycoplasma / Chlamydophila) · BTS 2023; IDSA
- COPD Exacerbation Management · NICE NG115 / GOLD 2024
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.