Inpatient vs. Outpatient Care for Pulmonary Embolism
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.
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.