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Early discharge after acute pulmonary embolism: keep quality of life on the radar

Kevin Solverson, Leslie Skeith, Jason Weatherald
European Respiratory Journal 2021 57: 2003811; DOI: 10.1183/13993003.03811-2020
Kevin Solverson
1Division of Respirology, Dept of Medicine, University of Calgary, Calgary, AB, Canada
2Dept of Critical Care Medicine, University of Calgary, Calgary, AB, Canada
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Leslie Skeith
3Division of Hematology and Hematological Malignancies, Dept of Medicine, University of Calgary, Calgary, AB, Canada
4Libin Cardiovascular Institute, Calgary, AB, Canada
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Jason Weatherald
1Division of Respirology, Dept of Medicine, University of Calgary, Calgary, AB, Canada
4Libin Cardiovascular Institute, Calgary, AB, Canada
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Extract

Patients with acute pulmonary embolism (PE) present with a spectrum of clinical severity and PE-related outcomes. In recent years, risk stratification based on clinical, biochemical and imaging features has been used to predict the risk of adverse events and determine optimal therapy for patients with PE. The European Society of Cardiology (ESC), in conjunction with the European Respiratory Society (ERS), published recent guidelines for the diagnosis and management of acute PE that support the use of stratification of patients into risk categories to determine the management strategy with an optimal risk–benefit ratio (class I, level B recommendation) [1]. Patients with PE who have haemodynamic instability have the highest risk of mortality and warrant urgent revascularisation. There is a large group of intermediate risk patients who are haemodynamically stable but have other risk features, such as significant tachycardia or right ventricular (RV) dysfunction, for which therapy beyond anticoagulation remains controversial. In contrast, patients who are haemodynamically stable with no high-risk features may be considered for oral anticoagulation and outpatient management [1].

Abstract

Quality of life improves following early discharge for acute PE, but not for all patients. Clinicians need to understand factors affecting quality of life for a given patient and must identify patients needing more support after discharge. https://bit.ly/35dWzgV

Footnotes

  • Conflict of interest: K. Solverson has nothing to disclose.

  • Conflict of interest: L. Skeith reports grants from CSL Behring, non-financial support from LEO Pharma, outside the submitted work.

  • Conflict of interest: J. Weatherald reports grants, personal fees and non-financial support from Janssen Inc. and from Actelion, personal fees and non-financial support from Bayer, personal fees from Novartis, outside the submitted work.

  • Received October 12, 2020.
  • Accepted October 13, 2020.
  • Copyright ©ERS 2021
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Vol 57 Issue 2 Table of Contents
European Respiratory Journal: 57 (2)
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Early discharge after acute pulmonary embolism: keep quality of life on the radar
Kevin Solverson, Leslie Skeith, Jason Weatherald
European Respiratory Journal Feb 2021, 57 (2) 2003811; DOI: 10.1183/13993003.03811-2020

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Early discharge after acute pulmonary embolism: keep quality of life on the radar
Kevin Solverson, Leslie Skeith, Jason Weatherald
European Respiratory Journal Feb 2021, 57 (2) 2003811; DOI: 10.1183/13993003.03811-2020
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