Outpatient management of stable acute pulmonary embolism: Proposed accelerated pathway for risk stratification

Pulmonary embolism ( PE) is a major health problem and a cause of worldwide morbidity and mortality. The current standard therapy for acute PE encourages admitting patients to the hospital for administration of parenteral anticoagulation therapy as a bridge to oral vitamin K antagonists. Prognostic models that identify patients with stable ( nonmassive) acute PE ( SPE) who are at low risk for adverse outcome have recently been reported. Based on these risk stratification models, hospital- based therapy is warranted for patients with PE who meet the criteria associated with a high risk for adverse outcome. However, a growing body of evidence suggests the feasibility of partial outpatient management and accelerated hospital discharge ( AHD) in a subset of patients with SPE. Prospective validation of these risk stratification models for predicting patient suitability for AHD is needed. (C) 2007 Elsevier Inc. All rights reserved.