Pulmonary Embolism Adverse Events for Outpatients vs Inpatients

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Stable PE may be managed via outpatient care.
Stable PE may be managed via outpatient care.

HealthDay News – For patients with hemodynamically stable pulmonary embolism (PE), outpatient management is associated with a lower rate of adverse events, according to research published online in the Journal of Thrombosis and Haemostasis.

Pierre-Marie Roy, MD, PhD, from Université d'Angers in France, and colleagues conducted a retrospective cohort propensity score analysis to determine the net clinical benefit of hospitalization vs outpatient management of normotensive patients with acute PE. A total of 1081 hemodynamically stable PE patients were included in the matched cohort: 576 were treated as inpatients and 505 as outpatients.

The researchers found that the 14-day rate of adverse events was 13.0% and 3.3% for inpatients and outpatients, respectively (adjusted odds ratio [OR], 5.07). For inpatients and outpatients, the 3-month adverse event rate was 21.7% and 6.9%, respectively (OR, 4.90). The 14-day rate of adverse events was 16.5% and 4.5% in the high-risk subgroup for hospitalized patients and outpatients, respectively (OR, 4.16).

"Outpatient treatment of hemodynamically stable PE patients seems [to be] associated with a lower rate of adverse events than hospitalization and, if confirmed, may be considered as first-line management in patients not requiring specific in-hospital care, regardless of their initial risk stratification, if proper outpatient care can be provided," the authors wrote.

Reference

Roy P-M, Corsi DJ, Carrier M, et al. Net clinical benefit of hospitalization vs outpatient management of patients with acute pulmonary embolism [published online January 20, 2017]. J Thromb Haemost. doi: 10.1111/jth.13629

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