Hospital at Home Unit, Department of Medicine, Hospital Clínico San Carlos, c/Prof. Martin Lagos, s/n 28040, Madrid, Spain.
Eur J Intern Med. 2009 Oct;20(6):598-600. doi: 10.1016/j.ejim.2009.04.003. Epub 2009 May 9.
The objective of this study is to compare the characteristics, outcomes, and clinical complications of patients with pulmonary embolism (PE) who were treated at home as outpatients versus traditional hospitalization.
Prospective study from January 2006 to June 2007. Selected patients diagnosed at the Emergency Department with stable non-massive pulmonary embolism that met standard inclusion criteria of Hospital at Home (HH) were treated at home. Patients that did not meet these criteria were admitted to Conventional Hospitalization (CH). Major and minor bleeding, re-thrombosis, clinical course, unexpected returns to hospital, and need for hospital re-admission in the following 3 months were recorded.
61 patients with PE were included (30 HH and 31 CH). Mean age 66.8 and 66.7 years in HH and CH, respectively. A history of neoplasm was found to be present in 13.3% and 9.7% of HH and CH patients. In the CH group, 19.3% of patients had prior thromboembolic disease. Concomitant DVT was seen in 40% and 29% of HH and CH patient. Pulmonary embolism was bilateral in 30% and 38.7% of HH and CH patients. No major bleeding, re-thrombosis, or death occurred. The home treatment was successfully completed in 100% of the patients. Three patients in the CH group had hospital-acquired infections.
Patients with stable non-massive pulmonary embolism may be safely treated under conditions of home hospitalization.
本研究旨在比较在家中作为门诊患者接受治疗与传统住院治疗的肺栓塞（PE）患者的特征、结局和临床并发症。
这是一项 2006 年 1 月至 2007 年 6 月进行的前瞻性研究。选择在急诊科诊断为稳定型非大面积肺栓塞且符合家庭医院（HH）标准纳入标准的患者进行家庭治疗。不符合这些标准的患者则收入传统住院治疗（CH）。记录主要和次要出血、再血栓形成、临床病程、意外返回医院以及在接下来的 3 个月内再次住院的需求。
共纳入 61 例 PE 患者（HH 组 30 例，CH 组 31 例）。HH 组和 CH 组患者的平均年龄分别为 66.8 岁和 66.7 岁。HH 组和 CH 组患者分别有 13.3%和 9.7%有肿瘤病史。CH 组中有 19.3%的患者有既往血栓栓塞病史。HH 组和 CH 组分别有 40%和 29%的患者同时合并下肢深静脉血栓形成。HH 组和 CH 组分别有 30%和 38.7%的患者的肺栓塞为双侧。无大出血、再血栓形成或死亡发生。HH 组 100%的患者成功完成了家庭治疗。CH 组中有 3 例患者发生医院获得性感染。
稳定型非大面积肺栓塞患者可在家中安全接受条件治疗。
