Little Change Seen in Rates of ED Discharge After Acute Pulmonary Embolism

MONDAY, Jan. 29, 2024 (HealthDay News) — For patients with acute pulmonary embolism (PE), the rates of discharge from the emergency department were stable between 2012 and 2020, according to a study published online Jan. 30 in the Annals of Internal Medicine.

Nathan W. Watson, from Harvard Medical School in Boston, and colleagues examined whether the proportion of discharges from emergency departments for acute PE changed from 2012 to 2020 in a serial cross-sectional analysis. There were approximately 1,635,300 visits for acute PE between 2012 and 2020.

The researchers found that the emergency department discharge rates remained constant over time, with rates of 38.2 and 33.4 percent between 2012 and 2014 and between 2018 and 2020, respectively (adjusted risk ratio, 1.01 per year; 95 percent confidence interval, 0.89 to 1.14). None of the baseline characteristics predicted an increased likelihood of emergency department discharge, including established risk stratification scores; however, the likelihood of receiving oral anticoagulation at discharge was increased for patients at teaching hospitals and those with private insurance. Overall, 35.9, 33.1, and 34.8 percent of patients who were considered low-risk according to their Pulmonary Embolism Severity Index (PESI) class, simplified PESI score, and hemodynamic stability, respectively, were discharged from the emergency department setting.

“Our findings show that outpatient management seems to have remained relatively unchanged during that period and that a considerable proportion of low-risk patients are still managed with inpatient hospitalization,” the authors write.

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