Inpatient vs. Outpatient Care for Pulmonary Embolism

Lower rate of adverse events for outpatients versus inpatients with hemodynamically stable PE
Lower rate of adverse events for outpatients versus inpatients with hemodynamically stable PE

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 January 20 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 versus outpatient management of normotensive patients with acute PE. A total of 1,081 hemodynamically stable PE patients were included in the matched cohort: 576 were treated as inpatients and 505 as outpatients. 

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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, 5.07). For inpatients and outpatients, the three-month adverse event rate was 21.7 and 6.9%, respectively (odds ratio, 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 (odds ratio, 4.16).

"Outpatient treatment of hemodynamically stable PE patients seems 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 write.

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