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Outpatient treatment options for pulmonary embolism

Publication at First Faculty of Medicine, Faculty of Medicine in Hradec Králové |
2019

Abstract

Pulmonary embolism (PE) is a serious and sometimes even fatal complication of venous thromboembolism (VTE). PE is typically managed in hospital, although a number of PE patients who are at a low risk of complications can be treated at home.

It is assumed that up to 50% of PE patients who are at a low risk of death can be candidates for an early discharge or for staying at home. Despite this fact, the reality is completely different, with most individuals diagnosed with acute PE being treated in hospital.

When treated at home, carefully selected low-risk PE patients have at least an equally good, if not better, prognosis compared with those who are treated in hospital. The selection of patients for outpatient PE treatment should, in routine practice, include the PESI or sPESI criteria supplemented by the Hestia exclusion criteria, and/or the European Society of Cardiology (ESC) criteria for the treatment of acute PE.

Direct oral anticoagulants are proving to be a very effective option for the home treatment of PE. Outpatient treatment of low-risk PE patients may potentially reduce the health care costs associated with PE treatment.