OPD management of acute pulmonary embolism

Health Care Comments Off

Not all symptomatic patients with acute pulmonary embolism need to be admitted to the hospital for initial therapy.

Patients with symptomatic acute PE and a low risk of death (PE severity index- PESI- low risk) can be treated as an OPD case with subcutaneous low molecular weight heparin (LMWH) followed by oral anticoagulation.

Prognostic models

The simplified PESI assigns a point for each of the following variables

  1. Age >80 years
  2. History of cancer
  3. Chronic cardiopulmonary disease
  4. Heart rate ≥110 beats per minute
  5. Systolic blood pressure <100 mmHg
  6. Arterial oxyhemoglobin saturation <90 percent.

A total point score of zero indicates a low risk for mortality, while a score of one or more indicates a high risk.