Immediate Discharge and Home Treatment With Rivaroxaban of Low-risk Venous Thromboembolism Diagnosed in Two U.S. Emergency Departments: A One-year Preplanned Analysis.

التفاصيل البيبلوغرافية
العنوان:	Immediate Discharge and Home Treatment With Rivaroxaban of Low-risk Venous Thromboembolism Diagnosed in Two U.S. Emergency Departments: A One-year Preplanned Analysis.
المؤلفون:	Beam DM; The Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN.; The Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, IN., Kahler ZP; The Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN., Kline JA; The Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN.; The Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, IN.
المصدر:	Academic emergency medicine : official journal of the Society for Academic Emergency Medicine [Acad Emerg Med] 2015 Jul; Vol. 22 (7), pp. 788-95. Date of Electronic Publication: 2015 Jun 25.
نوع المنشور:	Journal Article; Multicenter Study; Observational Study; Research Support, Non-U.S. Gov't
اللغة:	English
بيانات الدورية:	Publisher: Wiley Country of Publication: United States NLM ID: 9418450 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1553-2712 (Electronic) Linking ISSN: 10696563 NLM ISO Abbreviation: Acad Emerg Med Subsets: MEDLINE
أسماء مطبوعة:	Publication: Hoboken, N.J. : Wiley Original Publication: Philadelphia, PA : Hanley & Belfus, c1993-
مواضيع طبية MeSH:	Anticoagulants/therapeutic use , Emergency Service, Hospital/organization & administration , Pulmonary Embolism/drug therapy , Rivaroxaban/therapeutic use , Venous Thrombosis/*drug therapy, Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anticoagulants/administration & dosage ; Female ; Hemorrhage/chemically induced ; Humans ; Male ; Middle Aged ; Patient Discharge ; Patient Selection ; Prospective Studies ; Recurrence ; Risk Factors ; Rivaroxaban/administration & dosage ; United States ; Young Adult
مستخلص:	Objectives: The study hypothesis was that a target-specific anticoagulant would allow successful home treatment of selected patients with deep vein thrombosis (DVT) and pulmonary embolism (PE) diagnosed in two urban emergency departments (EDs). Methods: A protocol was established for treating low-risk DVT or PE patients with rivaroxaban and clinic, follow-up at both 2 to 5 weeks, and 3 to 6 months. Patients were determined to be low-risk by using a modified version of the Hestia criteria, supplemented by additional criteria for patients with active cancer. Acceptable outcome rates were defined as venous thromboembolism (VTE) recurrence ≤ 2.1% or bleeding ≤ 9.4% during treatment. VTE recurrence required positive imaging of any VTE. The International Society of Thrombosis and Hemostasis definition of major or clinically relevant nonmajor bleeding was used. Results: From March 2013 through April 2014, a total of 106 patients were treated. Seventy-one (68%) had DVT, 30 (28%) had PE, and five (3%) had both, representing 51% of all DVTs and 27% of all PEs diagnosed in both EDs during the period of study. The 106 patients have been followed for a mean (±SD) of 389 (±111) days (range = 213 to 594 days). No patient had VTE recurrence, and no patient had a major or clinically relevant bleeding event while on therapy (none of the 106, 0%, 95% confidence interval [CI] = 0% to 3.4%). However, three patients 2.8% (95% CI = 1% to 8%) had recurrent DVT after cessation of therapy. Conclusions: Patients diagnosed with VTE and immediately discharged from the ED while treated with rivaroxaban had a low rate of VTE recurrence and bleeding. (© 2015 by the Society for Academic Emergency Medicine.)
التعليقات:	Comment in: Acad Emerg Med. 2015 Nov;22(11):1355-7. (PMID: 26469358)
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المشرفين على المادة:	0 (Anticoagulants) 9NDF7JZ4M3 (Rivaroxaban)
تواريخ الأحداث:	Date Created: 20150627 Date Completed: 20160203 Latest Revision: 20220330
رمز التحديث:	20221213
مُعرف محوري في PubMed:	PMC5034796
DOI:	10.1111/acem.12711
PMID:	26113241
قاعدة البيانات:	MEDLINE

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تدمد:	1553-2712
DOI:	10.1111/acem.12711