Anna Remková
The results of several non-randomized studies of outcome in selected patients with proven acute uncomplicated pulmonary embolism (PE) suggest that their outpatient treatment is potentially safe and effective. The analyses showed, that a majority of patients (at least 50 %) presenting acutely with symptomatic PE can be managed as outpatients with a low risk of mortality, recurrent venous thromboembolism and major bleeding episodes. Patients are eligible for outpatient management of PE if they are considered to be low risk. These patients are those without serious comorbid conditions (cancer, heart failure or chronic lung disease etc.), who are haemodynamically stable (they have a normal pulse and blood pressure), do not require oxygen therapy, do not have contraindications to low-molecular-weight heparin therapy, are not felt to be high risk for a major haemorrhage, and are without other indications for hospital admission. Patients with PE selected with predefined criteria can be treated with anticoagulants on outpatient basis. It is certain that outpatient treatment of PE will continue, and it is quite likely to increase with the introduction of new oral anticoagulant drugs that obviate the need for injections and laboratory monitoring. >br<