Journal Mobile

CD Roseveare, J Rowlinson, J Deagle
Journal Issue: 
Volume 36: Issue 1: 2006




The objective of this study was to establish the feasibility and safety of managing  suspected  and  proven  PE  without  overnight  in-patient  stay  and  was designed  as  a  retrospective  review  of  experience.  The  study  took  place  at  the AMU, Southampton  General  Hospital, Southampton, England.  The  participants were consecutive patients between October 2002 and 2003 with clinical features suggesting  PE,  requiring  diagnostic  imaging,  and  who  fulfilled  pre-defined community   management   criteria. The main outcome measures were anticoagulation  complications, 30-day  re-admission, PE  within  six  months, and death any time following presentation.  The results were as follows: 133 patients were  identified, 22  of  whom  were  treated  in  the  community  for  PE  without significant complications.  Eight 30-day re-admissions were all in the ‘PE excluded’ group.  One re-admission may have related to anticoagulant therapy.  Five patients (4%) died during follow up. No deaths could be attributed to premature discharge or  management  in  the  community.  The  study  concluded  that  selected  patients with  suspected  and  proven  PE  may  be  managed  in  the  community  within  a carefully  defined  protocol, although  larger  studies  are  required  to  confirm  the safety of this approach.