Am J Emerg Med. 2020 Aug 22:S0735-6757(20)30700-2. doi: 10.1016/j.ajem.2020.08.016. Online ahead of print.
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.
PMID:33041137 | DOI:10.1016/j.ajem.2020.08.016