| Title: |
Comparison of two methods for selection of out of hospital treatment in patients with acute pulmonary embolism |
| Authors: |
Crobach, Monique J. T.; Dolsma, Anneke; Donker, Marjolein L.; Eijsvogel, Michiel; Faber, Laura M.; Hofstee, Herman M. A.; Kaasjager, Karin A. H.; Kruip, Marieke J. H. A.; Labots, Geert; Melissant, Christian F.; Sikkens, Michelle S. G.; Huisman, Menno V.; Zondag, Wendy; den Exter, Paul L. |
| Contributors: |
The Netherlands BV |
| Source: |
Thrombosis and Haemostasis ; volume 109, issue 01, page 47-52 ; ISSN 0340-6245 2567-689X |
| Publisher Information: |
Georg Thieme Verlag KG |
| Publication Year: |
2013 |
| Description: |
Summary The aim of this study is to compare the performance of two clinical decision rules to select patients with acute pulmonary embolism (PE) for outpatient treatment: the Hestia criteria and the simplified Pulmonary Embolism Severity Index (sPESI). From 2008 to 2010, 468 patients with PE were triaged with the Hestia criteria for outpatient treatment: 247 PE patients were treated at home and 221 were treated as inpatients. The outcome of interest was all-cause 30-day mortality. In a post-hoc fashion, the sPESI items were scored and patients were classified according to the sPESI in low and high risk groups. Of the 247 patients treated at home, 189 (77%) patients were classified as low risk according to the sPESI and 58 patients (23%) as high risk. In total, 11 patients died during the first month; two patients treated at home and nine patients treated in-hospital. None of the patients treated at home died of fatal PE. Both the Hestia criteria and sPESI selected >50% of patients as low risk, with good sensitivity and negative predictive values for 30-day mortality: 82% and 99% for the Hestia criteria and 91% and 100% for the sPESI, respectively. The Hestia criteria and the sPESI classified different patients eligible for out-patient treatment, with similar low risks for 30-day mortality. This study suggests that the Hestia criteria may identify a proportion of high risk sPESI patiennts who can be safely treated at home, this however requires further validation. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1160/th12-07-0466 |
| DOI: |
10.1160/TH12-07-0466.pdf |
| Availability: |
https://doi.org/10.1160/th12-07-0466; http://www.thieme-connect.de/products/ejournals/pdf/10.1160/TH12-07-0466.pdf |
| Accession Number: |
edsbas.A3DC86BA |
| Database: |
BASE |