[Evaluation of the management of low-risk pulmonary embolism diagnosed in an emergency department. HoPE study (Home treatment of Pulmonary Embolism)]

Abstract

Introduction: Risk stratification allows outpatient management of low-risk pulmonary embolism (PE). Here, we carry out an evaluation of the professional practices on the emergency management of low-risk PE, after selection with the sPESI score.

Material and method: All patients admitted to the emergency department of Chambéry hospital, with a final diagnosis of PE are analyzed. The PE of score sPESI at 0 are included, in the absence of contraindications. Ninety-day follow-up is done. The objective is to evaluate the proportion of ambulatory care for low-risk patients.

Results: Eighty PE were diagnosed in 2016, 28 with sPESI score at 0 and 3 patients excluded. Of the 25 inclusions, 6 patients had signs of right ventricular dysfunction and were therefore hospitalized. The remaining 19 were eligible for outpatient care but only 8 of them stayed less than 24hours in the hospital.

Discussion: The sPESI score is a decision support tool for outpatient management but should not be used alone. The search for right ventricular dysfunction seems important here.

Keywords: Ambulatoire; Bas risque; Dysfonction ventriculaire droite; Embolie pulmonaire; Low risk; Outpatient; Pulmonary embolism; Right ventricular dysfunction; SPESI score; Score sPESI.