دورية أكاديمية
Home Treatment of Pulmonary Embolism in the Era of Novel Oral Anticoagulants.
| العنوان: | Home Treatment of Pulmonary Embolism in the Era of Novel Oral Anticoagulants. |
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| المؤلفون: | Stein PD; Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing. Electronic address: steinp@msu.edu., Matta F; Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing., Hughes PG; Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing; Department of Medical Education, Summa Akron City Hospital, Ohio; Department of Emergency Medicine, McLaren Oakland Hospital, Pontiac, Mich., Hourmouzis ZN; Department of Medical Education, Summa Akron City Hospital, Ohio., Hourmouzis NP; Department of Medical Education, Summa Akron City Hospital, Ohio., White RM; Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing; Department of Emergency Medicine, Sparrow Health System, Lansing, Mich., Ghiardi MM; Department of Emergency Medicine, McLaren Oakland Hospital, Pontiac, Mich., Schwartz MA; Department of Emergency Medicine, University of Toledo Medical Center, Ohio., Moore HL; Department of Emergency Medicine, University of Toledo Medical Center, Ohio., Bach JA; Department of Emergency Medicine, St. Mary Mercy Hospital, Livonia, Mich., Schweiss RE; Department of Emergency Medicine, St. Mary Mercy Hospital, Livonia, Mich., Kazan VM; Department of Emergency Medicine, University of Toledo Medical Center, Ohio., Kakish EJ; Department of Emergency Medicine, University of Toledo Medical Center, Ohio., Keyes DC; Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing; Department of Emergency Medicine, St. Mary Mercy Hospital, Livonia, Mich., Hughes MJ; Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing; Department of Emergency Medicine, Sparrow Health System, Lansing, Mich. |
| المصدر: | The American journal of medicine [Am J Med] 2016 Sep; Vol. 129 (9), pp. 974-7. Date of Electronic Publication: 2016 Apr 21. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Excerpta Medica Country of Publication: United States NLM ID: 0267200 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1555-7162 (Electronic) Linking ISSN: 00029343 NLM ISO Abbreviation: Am J Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: New York, NY : Excerpta Medica Original Publication: New York, Donnelly. |
| مواضيع طبية MeSH: | Ambulatory Care/*statistics & numerical data , Anticoagulants/*therapeutic use , Pulmonary Embolism/*drug therapy, Administration, Oral ; Ambulatory Care/methods ; Anticoagulants/administration & dosage ; Emergency Service, Hospital/statistics & numerical data ; Female ; Heparin, Low-Molecular-Weight/therapeutic use ; Hospitalization/statistics & numerical data ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Warfarin/therapeutic use |
| مستخلص: | Background: Outpatient therapy of patients with acute pulmonary embolism has been shown to be safe in carefully selected patients. Problems related to the injection of low-molecular-weight heparin at home can be overcome by use of novel oral anticoagulants. The purpose of this investigation is to assess the prevalence of home treatment in the era of novel oral anticoagulants. Methods: This was a retrospective cohort study of patients aged ≥18 years with acute pulmonary embolism seen in 5 emergency departments from January 2013 to December 2014. Results: Pulmonary embolism was diagnosed in 983 patients. Among these, 237 were considered ineligible for home treatment because of instability or hypoxia. Home treatment was selected for 13 of 746 (1.7%) patients who were potentially eligible. Anticoagulant treatment for those treated at home was low-molecular-weight heparin or warfarin in 9 (69.2%) and novel oral anticoagulants in 4 (30.8%). Hospitalization was chosen for 733 of 746 (98.3%). Discharge in ≤2 days was in 119 patients (16.2%). Treatment of these patients was low-molecular-weight heparin or warfarin in 76 (63.9%), novel oral anticoagulants in 34 (28.6%), and in 9 (7.6%), anticoagulants were not given because of metastatic cancer or treatment was not known. Conclusion: Even in the era of novel oral anticoagulants, the vast majority of patients with acute pulmonary embolism were hospitalized, and only a small proportion were discharged in ≤2 days. Although home treatment has been found to be safe in carefully selected patients, and scoring systems have been derived to identify those at low risk of adverse events, home treatment was infrequently selected. (Copyright © 2016 Elsevier Inc. All rights reserved.) |
| التعليقات: | Comment in: Am J Med. 2016 Sep;129(9):899-900. (PMID: 27143322) |
| فهرسة مساهمة: | Keywords: Home treatment; Oral anticoagulants; Pulmonary embolism; Venous thromboembolism |
| المشرفين على المادة: | 0 (Anticoagulants) 0 (Heparin, Low-Molecular-Weight) 5Q7ZVV76EI (Warfarin) |
| تواريخ الأحداث: | Date Created: 20160425 Date Completed: 20170508 Latest Revision: 20220330 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1016/j.amjmed.2016.03.035 |
| PMID: | 27107921 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1555-7162 |
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| DOI: | 10.1016/j.amjmed.2016.03.035 |