Consider The Evidence: Med/Peds Journal Roundup

January 31, 2006

Treat and Street the PE

Filed under: archives of internal medicine, pulmonary — medblog @ 9:14 pm

ArchIM 1/23 – Now that we have LMWH in our toolbox, maybe patients can get treatment for pulmonary emboli in the comfort of their own home. Michael Fine, who helped create the mortality prediction rule for CAP, contributes on this Archives article that attempts to find the low-mortality risk subset of patients with PE. Maybe we can start treating these patients as outpatients as well?

The study identified 10 major risk factors: 10 patient factors (age >70 years; history of cancer, heart failure, chronic lung disease, chronic renal disease, and cerebrovascular disease; and clinical variables of pulse rate >110 beats/min, systolic blood pressure oxygen saturation were defined as low risk. Patients that met low risk criteria had a less than 1% mortality rate.

Bottom Line: PE patients without co-morbidities and relatively normal vitals / O2 sats have a low mortality risk. (good luck finding them)

A Prediction Rule to Identify Low-Risk Patients With Pulmonary Embolism
Drahomir Aujesky; D. Scott Obrosky; Roslyn A. Stone; Thomas E. Auble; Arnaud Perrier; Jacques Cornuz; Pierre-Marie Roy; Michael J. Fine
Arch Intern Med. 2006;166:169-175.

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