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

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.

[Outpatient management of pulmonary embolism diagnosed in emergency services]

In the emergency department, the management of patients with pulmonary embolism depends on the early mortality risk. Outpatient care is possible in low-risk patients. We present the existing scores and the strategy proposed by the North Alps Emergency Network, which uses the simplified PESI score (Pulmonary Embolism Severity Index) to select those low-risk patients, candidates for early discharge.