Only a small percentage of hospitalized patients with acute pulmonary embolism are discharged home from the emergency department, according to new research in the Academic Emergency Medicine journal.
Moreover, rates of outpatient management for acute PE varied widely between institutions.
“Although patients with PE have historically been admitted to the hospital for initial treatment, clinical trials have demonstrated the safety of treating carefully selected patients with acute PE as outpatients,” Lauren M. Westafer, DO, MPH, assistant professor in the Institute for Healthcare Delivery and Population Science and the department of emergency medicine at the University of Massachusetts Medical School, and colleagues wrote. “Protocols to manage patients with acute PE as outpatients were introduced in the late 1990s, and over the past 6 years an increasing number of international society guidelines recommended outpatient treatment of ED patients with low-risk PE.”
The retrospective cohort study included 61,070 adults (mean age, 61.6 years; 52.5% women) with newly diagnosed acute PE who were treated at 740 acute care hospitals in the U.S. from July 2016 to June 2018.
The primary outcome was initial disposition after an ED visit for acute PE. Secondary outcomes included hospital cost and the 30-day ED revisit rate.