title: Outpatient management of stable acute pulmonary embolism: proposed accelerated pathway for risk stratification.
abstract: Pulmonary embolism (PE) is a major health problem and a cause of worldwide morbidity and mortality. The current standard therapy for acute PE encourages admitting patients to the hospital for administration of parenteral anticoagulation therapy as a bridge to oral vitamin K antagonists. Prognostic models that identify patients with stable (nonmassive) acute PE (SPE) who are at low risk for adverse outcome have recently been reported. Based on these risk stratification models, hospital-based therapy is warranted for patients with PE who meet the criteria associated with a high risk for adverse outcome. However, a growing body of evidence suggests the feasibility of partial outpatient management and accelerated hospital discharge (AHD) in a subset of patients with SPE. Prospective validation of these risk stratification models for predicting patient suitability for AHD is needed.
authors.affiliation: Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02115, USA. aalmaham@bidmc.harvard.edu
authors.forename: Amjad
authors.initials: A
authors.lastname: Almahameed
authors.forename: Teresa L
authors.initials: TL
authors.lastname: Carman
mesh_terms: D000465:Algorithms; D000553:Ambulatory Care; D000925:Anticoagulants / Q000008:administration & dosage* / Q000627:therapeutic use; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D010045:Outpatients; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011655:Pulmonary Embolism / Q000188:drug therapy*; D015203:Reproducibility of Results; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents