Outpatient PE Care Studied

By Sharon Worcester

ATLANTA -- Outpatient management of pulmonary embolism is safe and effective in some patients, Dr. Susan Rhodes and her colleagues reported in a poster at the annual meeting of the American Society of Hematology.

In a phase II study of 106 patients with pulmonary embolism (PE), all patients received a mean of 7.6 days of low-molecular-weight heparin, with a mean of 5.5 days of treatment provided on an outpatient basis, said Dr. Rhodes of Swindon and Marlborough (England) National Health Service Trust.

About two-thirds (59%) of the patients were either not admitted to the hospital or spent less than 24 hours in the hospital.

No PE-related complications occurred in any of the patients during the treatment phase of the study. At 3-month follow-up, two patients had died of cancer, and another was lost to follow-up. The findings suggest that outpatient treatment for PE is feasible, cost effective, and acceptable in selected patients: those who are compliant, mobile, not pregnant, have no prior history of PE, have no coexisting major DVT, and have no active bleeding or bleeding disorder.

Dr. R. Eugene Zierler, professor of surgery, in the division of vascular surgery in the department of surgery of the University of Washington School of Medicine, Seattle, said in an interview that the results were "interesting and encouraging", but "must be interpreted with caution until the complete details are available for peer review." The patients were clearly a highly selected group, and the conclusions are not likely to be generalizable, since many patients with PE are not mobile and have coexisting DVT," he said.