Francesco Dentali1, Gianluca Di Micco2, Matteo Giorgi Pierfranceschi3, Gualberto Gussoni4, Giovanni Barillari5, Maria Amitrano6, Andrea Fontanella7, Corrado Lodigiani8, Anna Guida9, Adriana Visonà10, Manuel Monreal11, Pierpaolo Di Micco7. 1. a Department of Internal Medicine , Università dell'Insubria , Varese , Italy. 2. b Department of Cardiology , Ospedale Fatebenefratelli , Napoli , Italy. 3. c Emergency Department , Ospedale Val d'Arda , Piacenza , Italy. 4. d Centro Studi FADOI , Milano , Italy. 5. e Haemostasis and Thrombosis Center, Ospedale di Udine , Udine , Italy. 6. f Department of Angiology , AO Moscati , Avellino , Italy. 7. g Department of Internal Medicine , Ospedale Fatebenefratelli , Napoli , Italy. 8. h Thrombosis Center, IRCCS Istituto Clinico Humanitas , Milano , Italy. 9. i Critical Care Department , AOU S. Giovanni e Ruggi , Salerno , Italy. 10. j Department of Angiology , Castelfranco Veneto , Italy. 11. k Department of Internal Medicine , Hospital Universitari Germans Trias i Pujol , Badalona , Spain.
Abstract
BACKGROUND: Current guidelines recommend initial treatment with anticoagulants at home in patients with acute deep vein thrombosis (DVT) and in patients with low-risk pulmonary embolism (PE) with adequate home circumstances. However, most of the patients with acute venous thromboembolism (VTE) are currently hospitalized regardless of their risk of short-term complications. AIM OF THE STUDY: To assess the proportion of outpatients with acute VTE initially treated in hospitals, to assess the mean duration of hospitalization, and to identify predictors for in-hospital or home treatment. METHODS: Data of Italian patients enrolled in the RIETE registry from January 2006 to December 2013 were included. RESULTS: Altogether 766 PE and 1,452 isolated DVT were included. Among PE patients, mean PESI score was 84 points (SD 35), and 56% of patients had a low-risk PESI score (<85). In all, 53.7% of DVT and 17.0% of PE were entirely treated at home, and 38.2% of DVT patients and 19.9% of PE patients were hospitalized for ≤5 days. On multivariate analysis, low PESI score was not independently associated with the hospitalization of PE patients. CONCLUSIONS: One in every two patients with DVT and five in every six with PE are still hospitalized.
BACKGROUND: Current guidelines recommend initial treatment with anticoagulants at home in patients with acute deep vein thrombosis (DVT) and in patients with low-risk pulmonary embolism (PE) with adequate home circumstances. However, most of the patients with acute venous thromboembolism (VTE) are currently hospitalized regardless of their risk of short-term complications. AIM OF THE STUDY: To assess the proportion of outpatients with acute VTE initially treated in hospitals, to assess the mean duration of hospitalization, and to identify predictors for in-hospital or home treatment. METHODS: Data of Italian patients enrolled in the RIETE registry from January 2006 to December 2013 were included. RESULTS: Altogether 766 PE and 1,452 isolated DVT were included. Among PE patients, mean PESI score was 84 points (SD 35), and 56% of patients had a low-risk PESI score (<85). In all, 53.7% of DVT and 17.0% of PE were entirely treated at home, and 38.2% of DVT patients and 19.9% of PE patients were hospitalized for ≤5 days. On multivariate analysis, low PESI score was not independently associated with the hospitalization of PE patients. CONCLUSIONS: One in every two patients with DVT and five in every six with PE are still hospitalized.
Authors: Lisette F van Dam; Wilbert B van den Hout; Gargi Gautam; Charlotte E A Dronkers; Waleed Ghanima; Jostein Gleditsch; Anders von Heijne; Herman M A Hofstee; Marcel M C Hovens; Menno V Huisman; Stan Kolman; Albert T A Mairuhu; Mathilde Nijkeuter; Marcel A van de Ree; Cornelis J van Rooden; Robin E Westerbeek; Jan Westerink; Eli Westerlund; Lucia J M Kroft; Frederikus A Klok Journal: Blood Adv Date: 2021-03-09
Authors: Anthony J Weekes; Jaron D Raper; Kathryn Lupez; Alyssa M Thomas; Carly A Cox; Dasia Esener; Jeremy S Boyd; Jason T Nomura; Jillian Davison; Patrick M Ockerse; Stephen Leech; Jakea Johnson; Eric Abrams; Kathleen Murphy; Christopher Kelly; H James Norton Journal: PLoS One Date: 2021-11-18 Impact factor: 3.240
Authors: Robin Condliffe; Paul Albert; Raza Alikhan; Emma Gee; Daniel Horner; Laura Hunter; Phillip Jacobs; Rachel Limbrey; Michael Newnham; Wendy Preston; Sheena Patel; Laura-Jane Smith; Jay Suntharalingam Journal: BMJ Open Respir Res Date: 2020-08