Abstract:
:Pulmonary embolism (PE) is traditionally treated in hospital. Growing evidence from non randomized prospective studies suggests that a substantial proportion of patients with non-massive PE might be safely treated in the outpatient setting using low molecular weight heparins. Based on this evidence, professional societies started to recommend outpatient care for selected patients with non-massive PE. Despite these recommendations, outpatient treatment of non-massive PE appears to be uncommon in clinical practice. The major barriers to PE outpatient care are, firstly, the uncertainty as how to identify low risk patients with PE who are candidates for outpatient care and secondly the lack of high quality evidence from randomized trials demonstrating the safety of PE outpatient care compared to traditional inpatient management. Also, although clinical prognostic models, echocardiography and cardiac biomarkers accurately identify low risk patients with PE in prospective studies, the benefit of risk stratification strategies based on these instruments should be demonstrated in prospective management studies and clinical trials before they can be implemented as decision aids to guide PE outpatient treatment. Before high quality evidence documenting the safety of an outpatient treatment approach is published, outpatient management of non-massive PE cannot be generally recommended.
journal_name
Swiss Med Wklyjournal_title
Swiss medical weeklyauthors
Aujesky D,Mazzolai L,Hugli O,Perrier Adoi
smw-12661subject
Has Abstractpub_date
2009-11-28 00:00:00pages
685-90issue
47-48eissn
1424-7860issn
1424-3997pii
smw-12661journal_volume
139pub_type
杂志文章,评审abstract:BACKGROUND:Epidemiological studies focusing on first-ever seizures have been carried out mainly on community based populations. However, since hospital populations may display varying clinical features, we prospectively analysed patients with first-ever seizure in a hospital based community to evaluate prognosis and th...
journal_title:Swiss medical weekly
pub_type: 杂志文章
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pub_type: 杂志文章,meta分析,评审
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journal_title:Swiss medical weekly
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journal_title:Swiss medical weekly
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journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
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pub_type: 杂志文章
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pub_type: 杂志文章,随机对照试验
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更新日期:2006-04-15 00:00:00
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journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2001/05/smw-09667
更新日期:2001-02-10 00:00:00
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更新日期:2002-06-29 00:00:00
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更新日期:2008-05-03 00:00:00
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pub_type: 杂志文章
doi:2006/17/smw-11274
更新日期:2006-04-29 00:00:00