Publication:
Effect of Prognostic Guided Management of Patients With Acute Pulmonary Embolism According to the European Society of Cardiology Risk Stratification Model.

dc.contributor.authorJimenez, David
dc.contributor.authorRodriguez, Carmen
dc.contributor.authorPintado, Beatriz
dc.contributor.authorPerez, Andrea
dc.contributor.authorJara-Palomares, Luis
dc.contributor.authorLopez-Reyes, Raquel
dc.contributor.authorRuiz-Artacho, Pedro
dc.contributor.authorGarcia-Ortega, Alberto
dc.contributor.authorBikdeli, Behnood
dc.contributor.authorLobo, Jose Luis
dc.contributor.funderInstituto de Salud Carlos III
dc.contributor.groupIPEP investigators
dc.date.accessioned2023-05-03T13:39:39Z
dc.date.available2023-05-03T13:39:39Z
dc.date.issued2022-04-12
dc.description.abstractBackground: A recent trial showed that management driven by prognostic assessment was effective in reducing the length of stay (LOS) for acute stable pulmonary embolism (PE). The efficacy and safety of this strategy in each subgroup of risk stratification remains unknown. Methods : We conducted a post-hoc analysis of the randomized IPEP study to evaluate the effect of a management strategy guided by early use of a prognostic pathway in the low- and intermediate-high risk subgroups defined by the European Society of Cardiology (ESC) model. These subgroups were retrospectively identified in the control arm . The primary outcome was LOS. The secondary outcomes were 30-day clinical outcomes.Results: Of 249 patients assigned to the intervention group, 60 (24%) were classified as low-, and 30 (12%) as intermediate-high risk . Among 249 patients assigned to the control group , 66 (27%) were low-, and 13 (5%) intermediate-high risk . In the low- risk group, the mean LOS was 2.1 (±0.9) days in the intervention group and 5.3 (±2.9) days in the control group (P < 0.001). In this group, no significant differences were observed in 30-day readmissions (0% vs. 3.0%, respectively), all-cause (0% vs. 0%) and PE-related mortality rates (0% vs. 0%), or severe adverse events (0% vs. 1.5%). In the intermediate-high risk group, the mean LOS was 5.3 (±1.8) days in the intervention group and 6.5 (±2.5) days in the control group (P = 0.08). In this group, no significant differences were observed in 30-day readmissions (3.3% vs. 3.0%, respectively), all-cause (6.7% vs. 7.7%) and PE-related mortality rates (6.7% vs. 7.7%), or severe adverse events (16.7% vs. 15.4%).Conclusion: The use of a prognostic assessment and management pathway was effective in reducing the LOS for acute PE without comprising safety across subgroups of risk stratification.
dc.description.versionSi
dc.identifier.citationJiménez D, Rodríguez C, Pintado B, Pérez A, Jara-Palomares L, López-Reyes R, et al. Effect of Prognostic Guided Management of Patients With Acute Pulmonary Embolism According to the European Society of Cardiology Risk Stratification Model. Front Cardiovasc Med. 2022 Apr 12;9:872115.
dc.identifier.doi10.3389/fcvm.2022.872115
dc.identifier.issn2297-055X
dc.identifier.pmcPMC9039515
dc.identifier.pmid35497990
dc.identifier.pubmedURLhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9039515/pdf
dc.identifier.unpaywallURLhttps://www.frontiersin.org/articles/10.3389/fcvm.2022.872115/pdf
dc.identifier.urihttp://hdl.handle.net/10668/20549
dc.journal.titleFrontiers in cardiovascular medicine
dc.journal.titleabbreviationFront Cardiovasc Med
dc.language.isoen
dc.organizationHospital Universitario Virgen del Rocío
dc.organizationInstituto de Biomedicina de Sevilla-IBIS
dc.page.number7
dc.provenanceRealizada la curación de contenido 29/04/2025
dc.publisherFrontiers Research Foundation
dc.pubmedtypeJournal Article
dc.relation.projectIDPI15/00207
dc.relation.publisherversionhttps://doi.org/10.3389/fcvm.2022.872115
dc.rightsAttribution 4.0 International
dc.rights.accessRightsopen access
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectLOS
dc.subjectcomplications
dc.subjectmortality
dc.subjectprognosis
dc.subjectpulmonary embolism
dc.subject.decsRiesgo
dc.subject.decsMortalidad
dc.subject.decsPacientes
dc.subject.decsSeguridad
dc.subject.decsBrazo
dc.subject.decsEmbolia pulmonar
dc.subject.decsEficacia
dc.subject.decsCardiología
dc.subject.decsMétodos
dc.subject.meshHumans
dc.subject.meshPrognosis
dc.subject.meshControl Groups
dc.subject.meshRetrospective Studies
dc.subject.meshPatient Readmission
dc.subject.meshLength of Stay
dc.subject.meshCardiology
dc.subject.meshRisk Assessment
dc.titleEffect of Prognostic Guided Management of Patients With Acute Pulmonary Embolism According to the European Society of Cardiology Risk Stratification Model.
dc.typeresearch article
dc.type.hasVersionVoR
dc.volume.number9
dspace.entity.typePublication

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