Dentali Francesco, Di Micco Gianluca, Giorgi Pierfranceschi Matteo, Gussoni Gualberto, Barillari Giovanni, Amitrano Maria, Fontanella Andrea, Lodigiani Corrado, Guida Anna, Visonà Adriana, Monreal Manuel, Di Micco Pierpaolo
a Department of Internal Medicine , Università dell'Insubria , Varese , Italy.
b Department of Cardiology , Ospedale Fatebenefratelli , Napoli , Italy.
Ann Med. 2015;47(7):546-54. doi: 10.3109/07853890.2015.1085127. Epub 2015 Sep 30.
Current guidelines recommend initial treatment with anticoagulants at home in patients with acute deep vein thrombosis (DVT) and in patients with low-risk pulmonary embolism (PE) with adequate home circumstances. However, most of the patients with acute venous thromboembolism (VTE) are currently hospitalized regardless of their risk of short-term complications.
To assess the proportion of outpatients with acute VTE initially treated in hospitals, to assess the mean duration of hospitalization, and to identify predictors for in-hospital or home treatment.
Data of Italian patients enrolled in the RIETE registry from January 2006 to December 2013 were included.
Altogether 766 PE and 1,452 isolated DVT were included. Among PE patients, mean PESI score was 84 points (SD 35), and 56% of patients had a low-risk PESI score (<85). In all, 53.7% of DVT and 17.0% of PE were entirely treated at home, and 38.2% of DVT patients and 19.9% of PE patients were hospitalized for ≤5 days. On multivariate analysis, low PESI score was not independently associated with the hospitalization of PE patients.
One in every two patients with DVT and five in every six with PE are still hospitalized.
当前指南建议，对于急性深静脉血栓形成（DVT）患者以及家庭环境适宜的低风险肺栓塞（PE）患者，应在家中进行抗凝初始治疗。然而，目前大多数急性静脉血栓栓塞症（VTE）患者无论其短期并发症风险如何均住院治疗。
评估在医院接受初始治疗的急性VTE门诊患者比例，评估平均住院时间，并确定住院治疗或家庭治疗的预测因素。
纳入2006年1月至2013年12月在RIETE注册中心登记的意大利患者的数据。
共纳入766例PE患者和1452例孤立性DVT患者。在PE患者中，平均PESI评分为84分（标准差35），56%的患者PESI评分低风险（<85）。总体而言，53.7%的DVT患者和17.0%的PE患者完全在家中接受治疗，38.2%的DVT患者和19.9%的PE患者住院时间≤5天。多因素分析显示，低PESI评分与PE患者住院治疗无独立相关性。
每两名DVT患者中有一名、每六名PE患者中有五名仍住院治疗。
