Henry Han, Connor O'Hare, Elizabeth Joyce, Jeffrey A Kline, Colin F Greineder, Geoffrey D Barnes
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引用次数: 0
摘要
肺栓塞(PE)是急诊科常见的心血管疾病诊断,可导致严重的发病率和死亡率。诊断出肺栓塞后的第一步是使用风险评分(如肺栓塞严重程度指数和欧洲心脏病学会风险计划)对不良后果进行风险分层。虽然中危和高危 PE 患者应住院治疗,但越来越多的证据支持低危患者尽早出院并在家中接受抗凝治疗。Hestia 标准包含了临床医生对哪些患者适合提前出院的许多考虑因素,同时考虑了医疗和社会因素。此外,专业指南也为确定哪些低风险患者适合出院提供了算法。尽管如此,低风险急性 PE 患者仍经常需要住院治疗。在这篇综述中,我们以病例为基础,介绍了如何对患者进行风险分层和评估,以确定哪些患者适合尽早出院并接受家庭治疗。
JTH in Clinic: management of low-risk pulmonary embolism.
Pulmonary embolism (PE) is a common cardiovascular disease diagnosis in emergency departments that can be associated with significant morbidity and mortality. One of the first steps after diagnosing PE is to risk stratify for adverse outcomes using risk scores such as PE Severity Index and European Society of Cardiology risk scheme. While intermediate- and high-risk PE patients should be admitted to the hospital, there is increasing evidence to support early discharge and home-based anticoagulation therapy for low-risk patients. The Hestia criteria encompass many of the clinicians' considerations for who may be suitable for early discharge, considering both medical and social factors. Additionally, professional guidelines have provided algorithms on determining which low-risk patients may be suitable. Despite this, low-risk acute PE patients are still often admitted for inpatient treatment. In this review, we present a case-based approach on how to risk stratify and evaluate patients who may be good candidates for early discharge and home therapy.
期刊介绍:
The Journal of Thrombosis and Haemostasis (JTH) serves as the official journal of the International Society on Thrombosis and Haemostasis. It is dedicated to advancing science related to thrombosis, bleeding disorders, and vascular biology through the dissemination and exchange of information and ideas within the global research community.
Types of Publications:
The journal publishes a variety of content, including:
Original research reports
State-of-the-art reviews
Brief reports
Case reports
Invited commentaries on publications in the Journal
Forum articles
Correspondence
Announcements
Scope of Contributions:
Editors invite contributions from both fundamental and clinical domains. These include:
Basic manuscripts on blood coagulation and fibrinolysis
Studies on proteins and reactions related to thrombosis and haemostasis
Research on blood platelets and their interactions with other biological systems, such as the vessel wall, blood cells, and invading organisms
Clinical manuscripts covering various topics including venous thrombosis, arterial disease, hemophilia, bleeding disorders, and platelet diseases
Clinical manuscripts may encompass etiology, diagnostics, prognosis, prevention, and treatment strategies.