Efficacy and safety of outpatient treatment with direct oral anticoagulation in pulmonary embolism

Journal of Thrombosis and Thrombolysis
Raein GhazvinianJohan Elf

Abstract

Anticoagulant treatment of acute pulmonary embolism (PE) has traditionally been hospital-based. The lesser need for monitoring with the increasingly used direct acting oral anticoagulants (DOAC) in comparison to warfarin potentially facilitates outpatient treatment of PE with these drugs. This study aimed to evaluate efficacy and safety of outpatient treatment of PE with DOAC. We extracted data from the Swedish quality registry for patients on oral anticoagulation (AuriculA) for all 245 patients in the southernmost hospital region in Sweden (1.3 million inhabitants) selected for outpatient treatment with of PE with DOAC during 2013-2015. Comorbidites, risk factors, and simplified pulmonary embolism severity index were evaluated at baseline, and death, recurrent venous thromboembolism (VTE), and bleeding was recorded during 6 months of follow-up. Outpatient treatment was defined as discharge from the emergency department within 24 h. During 6 months of follow-up, one patient died during DOAC therapy, the cause of death was unrelated to VTE. No VTE recurrences occured, whereas, one patient experienced major bleeding, and five patients experienced minor bleedings. Outpatient treatment of PE with DOAC is efficient and safe in selec...Continue Reading

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Citations

Mar 7, 2019·The Cochrane Database of Systematic Reviews·Hugo Hb YooCathryn Broderick
Mar 10, 2019·Journal of Thrombosis and Haemostasis : JTH·W Frank Peacock, Adam J Singer
Mar 7, 2019·American Journal of Therapeutics·Antoniu Octavian PetrişCălin Pop
May 30, 2020·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·David R VinsonUNKNOWN CREST Network
Dec 2, 2020·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Raein GhazvinianAnders Gottsäter

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Clinical Trials Mentioned

NCT02811237

Software Mentioned

SPSS
AuriculA

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