Pulmonary Embolism: Some Patients Can Be Treated At Home

Main Category: Respiratory / Asthma
Also Included In: Blood / Hematology
Article Date: 28 Sep 2007 - 6:00 PDT

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Patients with a pulmonary embolism (PE; a blood clot in the lungs) are usually kept in hospital to receive anticoagulation with an injected drug, such as tinzaparin, until an oral anticoagulant becomes effective (warfarin). This has been the preferred way of treating patients with a similar but less serious condition, deep vein thrombosis (DVT; blood clots in the legs), for some years.

Although PE can be fatal, many patients remain relatively well apart from chest pains or some breathlessness.

Chris Davies (Royal Berkshire Hospital NHS Trust, London, UK) and his colleagues examined whether 157 selected patients with PE, who were thought to be at low risk of becoming more unwell or dying from PE or its treatment, could be managed on tinzaparin without staying in hospital once their condition had been diagnosed.

This study shows that patients who were at low risk of complications could receive treatment as an outpatient without any significant problems with medication, adverse effects or deaths. The patients who took part also completed a questionnaire about satisfaction with treatment at home, which shows that they found this a very acceptable way of managing the PE, thereby avoiding admission to hospital.

There is a significant saving in bed days, estimated to be approximately five days per person treated as an outpatient.

The next step in this area is to agree clear guidelines on which patients can be safely managed out of hospital and in doing so avoid admission altogether in some cases.

The European Respiratory Journal is the peer-reviewed scientific publication of the European Respiratory Society (more than 8,000 specialists in lung diseases and respiratory medicine in Europe, the United States and Australia).

European Respiratory Society