Introduction A service evaluation investigated the effect of follow-up in secondary care on the outcomes of patients who had suffered a Pulmonary Embolism (PE). Patients who attended the PE clinic received a tailored treatment plan specific to their PE event. Events were classified as provoked or unprovoked and their 2 year recurrence rates and complications assessed.
Method The 2012 cohort of 84 patients from a PE clinic was analysed retrospectively, allowing for a 2 year follow-up. Patients were classified as having sustained a provoked event if a transient provoking risk factor was identified, as per the European Society of Cardiology (ESC) 2014 guidelines.
Results Of the 84 patients (40 male, 44 female), 83 were available for follow-up at the 2 year mark. Fifty patients (59.5%) had a provoked event whilst 32 (38.1%) were unprovoked- 2 patients had inadequate history to assess. Patients with unprovoked events were investigated further to screen for an underlying malignancy. Three patients (9.38%) were diagnosed with malignancies within 6 months of their PE. Of the unprovoked, 26 underwent a thrombophilia screen with 4 (12.5%) testing positive. Of 83 patients followed to 2 years, 7 (8.4%) had a recurrence (median = 17 months). Two (2.4%) developed chronic thromboembolic pulmonary hypertension whilst 3 (3.6%) developed post-thrombotic syndrome.
Conclusion Compared to the ESC 2014 guidelines, recurrence rates and complications at 2 years are much lower. The classification of provoked and unprovoked events led to the diagnosis of unknown pathologies. Although only an initial study, this shows that secondary follow-up decreases adverse consequences.