Document Detail


Management of pulmonary embolism in the home.
MedLine Citation:
PMID:  16138796     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To describe the characteristics, outcomes and treatment complications of patients with pulmonary embolism (PE) who were treated at home and as outpatients in an ambulatory care program. METHODS: Retrospective descriptive study of patients with PE who were treated in the ambulatory care unit during 2003. Ambulatory care unit data and medical record information were reviewed. Data collected included demographic and clinical data, standard clinical indicators of unplanned admission during treatment program, incidence of major bleeding, recurrent venous thromboembolism (VTE), and death within 3 months of admission into the ambulatory care program. RESULTS: 130 patients with PE were treated: 46% were treated totally as outpatients and 54% as early discharge patients. Mean age was 66.4 years; 61% were women. The program was successfully completed for 89% of patients; one patient was lost to follow-up. There were three episodes of major bleeding (2%; 95% CI, 0.5%-7%), all in patients aged > 70 years. Four patients died (3%; 95% CI, 0.8%-8%) within 3 months of admission into the program, but none in the first week, no death being directly attributable to PE. There were seven episodes of recurrent VTE (5%; 95% CI, 2%-11%). CONCLUSION: Appropriately selected patients with sub-massive PE can be treated as outpatients and in the home. Although the outcome is good in most patients, a significant proportion will require admission, emphasising the need for a well defined protocol and close medical supervision. Further study will more closely define at-risk patients and refine the care pathways.
Authors:
Bin S Ong; Margaret A Karr; Daniel K Y Chan; Anthony Frankel; Qing Shen
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Medical journal of Australia     Volume:  183     ISSN:  0025-729X     ISO Abbreviation:  Med. J. Aust.     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-09-05     Completed Date:  2005-12-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0400714     Medline TA:  Med J Aust     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  239-42     Citation Subset:  IM    
Affiliation:
Department of Ambulatory Care, Bankstown-Lidcombe Hospital, Locked Mail Bag 1600, Bankstown, NSW 2200, Australia. bin.ong@swsahs.nsw.gov.au
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Distribution
Aged
Aged, 80 and over
Ambulatory Care / statistics & numerical data
Female
Hemorrhage / etiology
Home Care Services / statistics & numerical data*
Hospitalization / statistics & numerical data
Humans
Male
Middle Aged
New South Wales
Outcome and Process Assessment (Health Care)
Pulmonary Embolism / complications,  nursing*
Recurrence
Retrospective Studies
Sex Distribution
Survival Analysis
Comments/Corrections
Comment In:
Med J Aust. 2006 Feb 6;184(3):142-3; author reply 143-4   [PMID:  16460307 ]
Med J Aust. 2005 Sep 5;183(5):228-9   [PMID:  16138792 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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