Outpatient treatment of pulmonary embolism: A single center 4-year experience.


Journal

The American journal of emergency medicine
ISSN: 1532-8171
Titre abrégé: Am J Emerg Med
Pays: United States
ID NLM: 8309942

Informations de publication

Date de publication:
07 2021
Historique:
received: 08 06 2020
revised: 20 07 2020
accepted: 05 08 2020
pubmed: 13 10 2020
medline: 31 8 2021
entrez: 12 10 2020
Statut: ppublish

Résumé

Pulmonary embolus (PE) is associated with significant utilization of health resources. As patients can be risk-stratified, there is an opportunity for a subset of patients to be safely treated without hospitalization, thus reducing the associated costs of treatment. Our aim was to describe the population, treatment strategies, complications, and outcomes associated with outpatient management of PE following treatment in the ED. This retrospective health records survey investigated a 4-year cohort of patients presenting with PE who were discharged to home. Data from 151 patients demonstrated that 78% (118/151) of patients were discharged directly home; 19% (28/151) were discharged following ED clinical decision unit observation. Treatment with a novel oral anticoagulant was provided in 40% of cases (61/151). Six patients (4%) experienced a medication-related complication; 26 (17%) had a return visit within 30 days. In this cohort of patients with PE, outpatient management was safe and effective for the large majority. Immediate and 30-day complications were few.

Sections du résumé

BACKGROUND
Pulmonary embolus (PE) is associated with significant utilization of health resources. As patients can be risk-stratified, there is an opportunity for a subset of patients to be safely treated without hospitalization, thus reducing the associated costs of treatment. Our aim was to describe the population, treatment strategies, complications, and outcomes associated with outpatient management of PE following treatment in the ED.
METHODS
This retrospective health records survey investigated a 4-year cohort of patients presenting with PE who were discharged to home.
RESULTS
Data from 151 patients demonstrated that 78% (118/151) of patients were discharged directly home; 19% (28/151) were discharged following ED clinical decision unit observation. Treatment with a novel oral anticoagulant was provided in 40% of cases (61/151). Six patients (4%) experienced a medication-related complication; 26 (17%) had a return visit within 30 days.
CONCLUSION
In this cohort of patients with PE, outpatient management was safe and effective for the large majority. Immediate and 30-day complications were few.

Identifiants

pubmed: 33041137
pii: S0735-6757(20)30700-2
doi: 10.1016/j.ajem.2020.08.016
pii:
doi:

Substances chimiques

Anticoagulants 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

169-172

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Anne Huyler (A)

Department of Emergency Medicine, Maine Medical Center, 47 Bramhall St. Portland, ME 04101, USA.

Casey Z MacVane (CZ)

Department of Emergency Medicine, Maine Medical Center, 47 Bramhall St. Portland, ME 04101, USA.

Tania Strout (T)

Department of Emergency Medicine, Maine Medical Center, 47 Bramhall St. Portland, ME 04101, USA.

Andrew D Perron (AD)

Department of Emergency Medicine, Maine Medical Center, 47 Bramhall St. Portland, ME 04101, USA. Electronic address: perroa@mmc.org.

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Classifications MeSH