Abstract
Introduction: PE is usually investigated and treated as in-patient but there is growing evidence that significant proportion of patients might be safely managed in the out patient setting with low molecular weight heparin (LMWH).
Aims: To assess compliance and safety of our hospital pathway for out-patient management of suspected PE.
Methods: We studied a prospective cohort of patients with suspected PE managed as outpatients using LMHW from the day of presentation untill either the diagnosis of PE was excluded or confirmed. We analysed patients referred to ambulatory care clinic with suspected PE from June 2009 till June 2010. 42 patients met the inclusion criteria. All patients were reviewed in clinic after a V/Q scan or CTPA.
Results: 16 (38%) patients were diagnosed with PE. Average time taken for PE to be diagnosed or excluded was 57 hours. There were no deaths or complications recorded from either PE or LMWH. No significant differences in clinical and physiological parameters were noted except for systolic BP (p 0.043).
Conclusion: Its probably safe to investigate and treat suspected PE as outpatient in selected clinically stable patients. Larger multi-centre randomised controlled trials are needed to confirm this finding.
- © 2011 ERS