Hestia criteria can safely select patients with pulmonary embolism for outpatient treatment irrespective of right ventricular function

Summary Background There has been debate over how patients with pulmonary embolism (PE) can be safely selected for outpatient treatment. Objectives To compare the Hestia criteria with the European Society of Cardiology (ESC) criteria for selecting low‐risk patients with PE for outpatient treatment....

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Bibliographic Details
Published in:Journal of thrombosis and haemostasis 2013-04, Vol.11 (4), p.686-692
Main Authors: Zondag, W., Vingerhoets, L. M. A., Durian, M. F., Dolsma, A., Faber, L. M., Hiddinga, B. I., Hofstee, H. M. A., Hoogerbrugge, A. D. M., Hovens, M. M. C., Labots, G., Vlasveld, T., Vreede, M. J. M., Kroft, L. J. M., Huisman, M. V.
Format: Article
Language:English
Subjects:
adverse outcome
Aged
Female
home treatment
Humans
Male
Middle Aged
mortality
Netherlands
outpatient treatment
Outpatients
Prospective Studies
pulmonary embolism
Pulmonary Embolism - physiopathology
Pulmonary Embolism - therapy
risk
Ventricular Function, Right
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Summary:Summary Background There has been debate over how patients with pulmonary embolism (PE) can be safely selected for outpatient treatment. Objectives To compare the Hestia criteria with the European Society of Cardiology (ESC) criteria for selecting low‐risk patients with PE for outpatient treatment. Methods From 2008 to 2010, 496 patients with acute, symptomatic PE were screened and 275 treated at home and 221 treated in the hospital according to the Hestia Study protocol. The Hestia criteria were used to select patients for outpatient treatment. Right and left ventricular (RV and LV) diameters were measured on computed tomography images. RV dysfunction was defined as an RV/LV ratio > 1.0. Patients were classified according to the ESC criteria into low, intermediate and high‐risk groups, based on blood pressure and RV dysfunction. During 3 months follow‐up adverse events were scored. Results Adverse events occurred in 22 patients (4.5%) treated in the hospital vs. none of the patients treated at home (P 
ISSN:1538-7933
1538-7836
1538-7836
DOI:10.1111/jth.12146