Home Treatment for Low-risk Pulmonary Embolism: Is it Happening?

Abstract

Patients with pulmonary embolus (PE) can be stratified into low, intermediate, and high risk based on such factors as hemodynamics and the status of the right ventricle. Low risk patients who meet appropriate criteria can potentially be discharged home with oral anticoagulation, avoiding unnecessary hospitalization and associated complications and costs. However, limited data suggest early discharge of low-risk patients has not gained widespread traction. This retrospective study reviewed 138 patients seen in a high-volume emergency department (ED), 29 of whom were considered low-risk. Of these, 24 (82.7%) were still admitted to the hospital despite meeting appropriate criteria for early discharge. This suggests early discharge of low-risk PE patients is underutilized. A variety of quality improvement measures can be implemented to increase adoption of this approach.