Outpetient treatmetn f PE – pro
30 to 50 percent of patients with acute PE diagnoses may be eligible for outpatient management. Outpatient management is associated with lower costs—the median hospital cost among patients discharged from U.S. emergency departments with acute PEs between 2016 and 2018 was $986 compared to $6,130 for those admitted to the hospital.5 Other benefits of outpatient management include reduced risk of hospital-acquired conditions and reduced hospital capacity strain. Randomized trials and several observational studies demonstrate that patients with low-risk PE can be managed safely as outpatients.4,6–8 A systematic review of PE’s outpatient management found that all-cause and PE-related mortality at 30 days was less than 1 percent among high-quality studies.
The American College of Chest Physicians recommends outpatient care for adults who meet the following criteria: “(1) clinically stable with good cardiopulmonary reserve; (2) no contraindications such as recent bleeding, severe renal or liver disease, or severe thrombocytopenia (i.e., < 50,000 per mm3); (3) expected to be compliant with treatment; and (4) the patient feels well enough to be treated at home.” The patient must also have access to treatment and follow-up care.
Stevens SM, Woller SC, Baumann Kreuziger L, et al. Executive summary: antithrombotic therapy for VTE disease: second update of the CHEST guideline and expert panel report. Chest. 2021;160(6):2247-2259.
Vinson DR, Aujesky D, Geersing GJ, et al. Comprehensive outpatient management of low-risk pulmonary embolism: can primary care do this? A narrative review. Perm J. 2020;24 : 19.163.
Bellou E, Keramida E, Karampinis I, Dimakakos E, Misthos P, Demertzis P, Hardavella G. Outpatient treatment of pulmonary embolism. Breathe (Sheff). 2020 Sep;16(3):200069.