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Clinical studies in pulmonary embolism
P256 Investigating suspected pulmonary embolism as outpatient: the Portsmouth experience
  1. I Shafiq,
  2. N Siddique,
  3. A J Chauhan,
  4. L Albon,
  5. V King,
  6. S R Alapati
  1. Queen Aexandra Hospital, Portsmouth, UK

Abstract

Introduction Suspected PE is a commonacute medical presentation. It continues to be a significant burden on the healthcare resources, hence it makes sense to investigate and manage stable patients with suspected PE as outpatient. There is very limited evidence available on the safety of investigation of PE as outpatient. The aim of this study was to review the outcomes of investigation for PE on outpatient basis.

Methods During 6 months period from November 2007 to April 2008, 176 patients were investigated for suspected pulmonary embolism as outpatient, based on clinical criteria of stability (eg notachycardia, tachypnea or hypotension). All of these patients were treated withenoxaparin from the day of admission till the diagnosis of PE was confirmed or excluded. We randomly selected 92 of these patients and retrospectively reviewed their clinical notes. The data recorded included pulse, blood pressure, respiratory rate, PO2, PCO2, Trop t and D.dimer. We also looked at the number of days patients had to wait for the CTPA or VQ scan. All patients were reviewed in clinic after a VQ scan or CTPA.

Results 12 out of 91 (13.2%) patients were diagnosed with PE. There were no deaths and no significant complications recorded from either PE or enoxaparin therapy. Average time taken for PE to be diagnosed or excluded was 3.86 days. There were no significant differences in clinical or physiological parameters between groups apart from PO2, which was significantly lower in the group with PE (p 0.032) (Abstract P256 Table 1).

Conclusions We conclude from this small series that it may be safe to investigate suspected PE as outpatient in selected clinically stable patients, though this needs to be confirmed in larger studies with an evaluation of health economic benefits.

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