OUTPATIENT TREATMENT OF PULMONARY EMBOLISM - A SINGLE-CENTER EXPERIENCE

被引:0
作者
Hamzic, Jasmin [1 ]
Gornik, Ivan [1 ]
机构
[1] Univ Hosp Ctr Zagreb, Emergency Dept, Kispaticeva 12, Zagreb 10000, Croatia
关键词
pulmonary embolism; emergency department; early discharge; outpatient treatment; LOW-RISK PATIENTS; PROGNOSTIC MODEL; VALIDATION;
D O I
10.20471/acc.2022.61.s1.06
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Pulmonary embolism (PE) is a common diagnosis in an emergency department. It also represents a large share of patients admitted to hospital wards. Patients with PE can be risk-stratified and discharged early from the emergency department. This results in better availability of hospital beds for other patients and a significant reduction of treatment costs for the healthcare system. This paper aims to describe the protocols used in our emergency department, with special emphasis on risk stratification, for adverse events and bleeding risk, treatment strategies, and outcomes for this type of protocol. Materials and methods: This paper is a retrospective analysis of patients discharged from the emergency department in a of two-year period (2020-2021) with a low-risk pulmonary embolism. Results: We have included in this study 42 patients discharged after a short-term observation from the emergency department (<24h) or short-term hospitalization; <24h). Ninety-one percent of patients were discharged with direct oral anticoagulant as a treatment for PE. We did not notice any adverse events (hemorrhage, progression of PE, or major cardiovascular issues). Conclusion: In the cohort of patients with PE, early discharge and outpatient treatment was safe and effective, with lower healthcare costs and almost no adverse events for patients
引用
收藏
页码:38 / 43
页数:6
相关论文
共 14 条
[1]   Validation of a clinical prognostic model to identify low-risk patients with pulmonary embolism [J].
Aujesky, D. ;
Perrier, A. ;
Roy, P.-M. ;
Stone, R. A. ;
Cornuz, J. ;
Meyer, G. ;
Obrosky, D. S. ;
Fine, M. J. .
JOURNAL OF INTERNAL MEDICINE, 2007, 261 (06) :597-604
[2]   Derivation and validation of a prognostic model for pulmonary embolism [J].
Aujesky, D ;
Obrosky, DS ;
Stone, RA ;
Auble, TE ;
Perrier, A ;
Cornuz, J ;
Roy, PM ;
Fine, MJ .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2005, 172 (08) :1041-1046
[3]   Prediction of bleeding events using the VTE-BLEED risk score in patients with venous thromboembolism receiving anticoagulant therapy (Review) [J].
Badescu, Minerva Codruta ;
Ciocoiu, Manuela ;
Badulescu, Oana Viola ;
Vladeanu, Maria-Cristina ;
Bojan, Iris Bararu ;
Vlad, Cristiana Elena ;
Rezus, Ciprian .
EXPERIMENTAL AND THERAPEUTIC MEDICINE, 2021, 22 (05)
[4]   Early discharge and home treatment of patients with low-risk pulmonary embolism with the oral factor Xa inhibitor rivaroxaban: an international multicentre single-arm clinical trial [J].
Barco, Stefano ;
Schmidtmann, Irene ;
Ageno, Walter ;
Bauersachs, Rupert M. ;
Becattini, Cecilia ;
Bernardi, Enrico ;
Beyer-Westendorf, Jan ;
Bonacchini, Luca ;
Brachmann, Johannes ;
Christ, Michael ;
Czihal, Michael ;
Duerschmied, Daniel ;
Empen, Klaus ;
Espinola-Klein, Christine ;
Ficker, Joachim H. ;
Fonseca, Candida ;
Genth-Zotz, Sabine ;
Jimenez, David ;
Harjola, Veli-Pekka ;
Held, Matthias ;
Prat, Lorenzo Iogna ;
Lange, Tobias J. ;
Manolis, Athanasios ;
Meyer, Andreas ;
Mustonen, Pirjo ;
Rauch-Kroehnert, Ursula ;
Ruiz-Artacho, Pedro ;
Schellong, Sebastian ;
Schwaiblmair, Martin ;
Stahrenberg, Raoul ;
Westerweel, Peter E. ;
Wild, Philipp S. ;
Konstantinides, Stavros, V ;
Lankeit, Mareike .
EUROPEAN HEART JOURNAL, 2020, 41 (04) :509-518
[5]   Home treatment of patients with low-risk pulmonary embolism with the oral factor Xa inhibitor rivaroxaban Rationale and design of the HoT-PE Trial [J].
Barco, Stefano ;
Lankeit, Mareike ;
Binder, Harald ;
Schellong, Sebastian ;
Christ, Michael ;
Beyer-Westendorf, Jan ;
Duerschmied, Daniel ;
Bauersachs, Rupert ;
Empen, Klaus ;
Held, Matthias ;
Schwaiblmair, Martin ;
Fonseca, Candida ;
Jimenez, David ;
Becattini, Cecilia ;
Quitzau, Kurt ;
Konstantinides, Stavros .
THROMBOSIS AND HAEMOSTASIS, 2016, 116 (01) :191-197
[6]   Hospital Costs of Acute Pulmonary Embolism [J].
Fanikos, John ;
Rao, Amanda ;
Seger, Andrew C. ;
Carter, Danielle ;
Piazza, Gregory ;
Goldhaber, Samuel Z. .
AMERICAN JOURNAL OF MEDICINE, 2013, 126 (02) :127-132
[7]  
Gornik I, 2022, PDF BENEFIT APPL PRO
[8]   Simplification of the Pulmonary Embolism Severity Index for Prognostication in Patients With Acute Symptomatic Pulmonary Embolism [J].
Jimenez, David ;
Aujesky, Drahomir ;
Moores, Lisa ;
Gomez, Vicente ;
Luis Lobo, Jose ;
Uresandi, Fernando ;
Otero, Remedios ;
Monreal, Manuel ;
Muriel, Alfonso ;
Yusen, Roger D. .
ARCHIVES OF INTERNAL MEDICINE, 2010, 170 (15) :1383-1389
[9]   Multicenter Implementation of a Novel Management Protocol Increases the Outpatient Treatment of Pulmonary Embolism and Deep Vein Thrombosis [J].
Kabrhel, Christopher ;
Rosovsky, Rachel ;
Baugh, Christopher ;
Connors, Jean ;
White, Benjamin ;
Giordano, Nicholas ;
Torrey, Jasmine ;
Deadmon, Erin ;
Parry, Blair Alden ;
Hagan, Sean ;
Zheng, Hui .
ACADEMIC EMERGENCY MEDICINE, 2019, 26 (06) :657-669
[10]   Outpatient Treatment of Low-risk Pulmonary Embolism in the Era of Direct Oral Anticoagulants: A Systematic Review [J].
Maughan, Brandon C. ;
Frueh, Lisa ;
McDonagh, Marian S. ;
Casciere, Bryan ;
Kline, Jeffrey A. .
ACADEMIC EMERGENCY MEDICINE, 2021, 28 (02) :226-239