2019
DOI: 10.1093/eurheartj/ehz367
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Early discharge and home treatment of patients with low-risk pulmonary embolism with the oral factor Xa inhibitor rivaroxaban: an international multicentre single-arm clinical trial

Abstract: Aims To investigate the efficacy and safety of early transition from hospital to ambulatory treatment in low-risk acute PE, using the oral factor Xa inhibitor rivaroxaban. Methods and results We conducted a prospective multicentre single-arm investigator initiated and academically sponsored management trial in patients with acute low-risk PE (EudraCT Identifier 2013-001657-28). Eligibility criteria included absence of (i) hae… Show more

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Cited by 122 publications
(62 citation statements)
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“…Major bleeding occurred in six (1.2%) of the patients in the safety population. There were no PE-related deaths [319]. In view of the existing evidence-and taking into consideration (i) the catastrophic scenario of early death if a patient with acute PE is falsely judged to be at low risk on clinical grounds alone and discharged "too early" (as described in a prematurely terminated trial [328]), and (ii) the ease and minimal additional effort of assessing RV size and function at presentation by echocardiography, or on the CTPA performed to diagnose the PE event itself [329] (section 5)-it is wise to exclude RV dysfunction and right heart thrombi if immediate or early (within the first 24-48 h) discharge of the patient is planned.…”
Section: Management Of Low-risk Pulmonary Embolism: Triage For Early mentioning
confidence: 92%
See 1 more Smart Citation
“…Major bleeding occurred in six (1.2%) of the patients in the safety population. There were no PE-related deaths [319]. In view of the existing evidence-and taking into consideration (i) the catastrophic scenario of early death if a patient with acute PE is falsely judged to be at low risk on clinical grounds alone and discharged "too early" (as described in a prematurely terminated trial [328]), and (ii) the ease and minimal additional effort of assessing RV size and function at presentation by echocardiography, or on the CTPA performed to diagnose the PE event itself [329] (section 5)-it is wise to exclude RV dysfunction and right heart thrombi if immediate or early (within the first 24-48 h) discharge of the patient is planned.…”
Section: Management Of Low-risk Pulmonary Embolism: Triage For Early mentioning
confidence: 92%
“…Carefully selected patients with low-risk PE should be considered for early discharge and continuation of treatment at home, if proper outpatient care and anticoagulant treatment can be provided c [178,206,[317][318][319].…”
Section: Recommendations Class a Level Bmentioning
confidence: 99%
“…The main goal of management for patients with known or new-onset thrombotic disease but without COVID-19 is to provide sufficient antithrombotic protection, while minimizing physical contact between patients and healthcare workers and health systems. Outpatient management or early discharge for acute VTE should be instituted when possible (120)(121)(122), and early discharge after medication stabilization for low-risk ACS or PCI for high-risk ACS should be considered (100)(101)(102). Telemedicine should be the preferred method of follow-up, and inperson visits should be reserved only for scenarios that cannot be addressed by telemedicine, or that may potentially warrant hospitalization.…”
Section: Management Of Patients With Thromboembolic Disease Without Cmentioning
confidence: 99%
“…Major bleeding occurred in 6 of the 519 patients (1.2%) comprising the safety population suggesting that early discharge and home treatment with rivaroxaban is effective and safe in carefully selected patients with low-risk PE. 30…”
Section: Key Findingsmentioning
confidence: 99%