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

Ghazvinian, R. LU ; Gottsäter, A. LU and Elf, J. L. LU (2018) In Journal of Thrombosis and Thrombolysis
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... (More)

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 selected patients.

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author
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Direct oral anticoagulant, Outpatient treatment, Pulmonary embolism, Venous thromboembolism
in
Journal of Thrombosis and Thrombolysis
pages
6 pages
publisher
Springer
external identifiers
  • scopus:85040044754
ISSN
0929-5305
DOI
10.1007/s11239-017-1607-9
language
English
LU publication?
no
id
d595856c-c931-4375-a6cb-00b1dbf099c0
date added to LUP
2018-01-23 14:29:50
date last changed
2018-01-24 03:00:03
@article{d595856c-c931-4375-a6cb-00b1dbf099c0,
  abstract     = {<p>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 selected patients.</p>},
  author       = {Ghazvinian, R. and Gottsäter, A. and Elf, J. L.},
  issn         = {0929-5305},
  keyword      = {Direct oral anticoagulant,Outpatient treatment,Pulmonary embolism,Venous thromboembolism},
  language     = {eng},
  month        = {01},
  pages        = {6},
  publisher    = {Springer},
  series       = {Journal of Thrombosis and Thrombolysis},
  title        = {Efficacy and safety of outpatient treatment with direct oral anticoagulation in pulmonary embolism},
  url          = {http://dx.doi.org/10.1007/s11239-017-1607-9},
  year         = {2018},
}