RT Journal Article
T1 Effect of Prognostic Guided Management of Patients With Acute Pulmonary Embolism According to the European Society of Cardiology Risk Stratification Model.
A1 Jimenez, David
A1 Rodriguez, Carmen
A1 Pintado, Beatriz
A1 Perez, Andrea
A1 Jara-Palomares, Luis
A1 Lopez-Reyes, Raquel
A1 Ruiz-Artacho, Pedro
A1 Garcia-Ortega, Alberto
A1 Bikdeli, Behnood
A1 Lobo, Jose Luis
K1 LOS
K1 complications
K1 mortality
K1 prognosis
K1 pulmonary embolism
AB Background: 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.
PB Frontiers Research Foundation
SN 2297-055X
YR 2022
FD 2022-04-12
LK http://hdl.handle.net/10668/20549
UL http://hdl.handle.net/10668/20549
LA en
NO Jiménez 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.
DS RISalud
RD Aug 17, 2025