TY - JOUR T1 - A retrospective analysis of outcomes in low- and intermediate–high-risk pulmonary embolism patients managed on an ambulatory medical unit in the UK JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00184-2018 VL - 5 IS - 2 SP - 00184-2018 AU - Michael E. Reschen AU - Jonathan Raby AU - Jordan Bowen AU - Sudhir Singh AU - Daniel Lasserson AU - Christopher A. O'Callaghan Y1 - 2019/04/01 UR - http://openres.ersjournals.com/content/5/2/00184-2018.abstract N2 - Pulmonary embolism (PE) is common and guidelines recommend outpatient care only for PE patients with low predicted mortality. Outcomes for patients with intermediate-to-high predicted mortality managed as outpatients are unknown.Electronic records were analysed for adults with PE managed on our ambulatory care unit over 2 years. Patients were stratified into low or intermediate-to-high mortality risk groups using the Pulmonary Embolism Severity Index (PESI). Primary outcomes were the proportion of patients ambulated, 30-day all-cause mortality, 30-day PE-specific mortality and 30-day re-admission rate.Of 199 PE patients, 74% were ambulated and at 30 days, all-cause mortality was 2% (four out of 199) and PE-specific mortality was 1% (two out of 199). Ambulated patients had lower PESI scores, better vital signs and lower troponin levels (morning attendance favoured ambulation). Over a third of ambulated patients had an intermediate-to-high risk PESI score but their all-cause mortality rate was low at 1.9% (one out of 52). In patients with intermediate-to-high risk, oxygen saturation was higher and pulse rate lower in those who were ambulated. Re-admission rate did not differ between ambulated and admitted patients.Two-thirds of patients with intermediate-to-high risk PE were ambulated and their mortality rate remained low. It is possible for selected patients with intermediate-to-high risk PESI scores to be safely ambulated.In a cohort of 199 patients with pulmonary embolism (PE), 52 were managed as outpatients despite an intermediate-to-high risk of mortality. Only 1 outpatient died within 30 days and not from PE, suggesting opportunities for increased ambulatory care. http://ow.ly/4p4D30oaNkr ER -