The optimal diagnosis strategy for pulmonary embolism (PE) in the emergency department (ED) remains complex. This review summarizes PE diagnosis with clinical presentation, decision rules and investigations for acute PE. This review was performed using studies published between January 1, 2010, and September 1, 2023. PE should be considered in ED in patients with chest pain, shortness of breath, syncope or signs of deep veinous thrombosis. Definitive diagnosis of PE relies on thoracic imaging, with the use of chest tomographic pulmonary angiogram or ventilation-perfusion lung scintigraphy. To limit the continuous increased use of chest imaging, the clinical probability should be the first step for PE workup. The pulmonary embolism rule-out criteria (PERC) can rule out PE at this stage. If not, for low or intermediate probability, several clinical decision rules have been validated, either by ruling out PE on clinical signs, or by raising D-dimer thresholds (YEARS or PEGeD [Pulmonary Embolism Graduated D-Dimer] criteria) or by combination of these different rules. It is recommended that patients with a high clinical probability of PE should undergo chest imaging without the need for D-dimer testing. The PE diagnostic approach can be tailored in specific populations such as pregnant, younger, COVID-19, or cancer patients. PE diagnosis workup illustrates the complexity of modern probabilistic-based approaches of decision-making in medicine. It is recommended to use a Bayesian approach with the evaluation of clinical probability, then order D-dimer if the PERC rule is positive, then adapt the D-dimer threshold for ordering chest imaging using clinical decision rules.
Citations
Citations to this article as recorded by
Advances and challenges in the emergency diagnosis of pulmonary embolism Héloise Bannelier, Theophile Vieux, Melanie Roussel Current Opinion in Critical Care.2026; 32(3): 239. CrossRef
Comprehensive Evaluation of the Diagnostic Approach to Pulmonary Embolism: Analysis of D-Dimer Utilization, Imaging Modalities (CTPA and V/Q Scan), and Clinical Risk Stratification Tools Muhammad Daud, Muhammad Anees, Hakim Ullah Wazir, Zaheer Ahmad, Zeeshan Umar, Wajeeha Arif, Sohail Ahmad, Nabila Fayaz, Sadaf Said Indus Journal of Bioscience Research.2025; 3(1): 449. CrossRef
Pulmonary embolism: pitfalls, unmet needs, and perspectives in emergency medicine Mélanie Roussel, Héloïse Bannelier European Journal of Emergency Medicine.2024; 31(3): 169. CrossRef
Objective Pulmonary embolism (PE) is a vascular disease that is most frequently diagnosed using the radiological imaging technique computed tomography pulmonary angiography (CTPA). In this study, we aimed to demonstrate the diagnostic accuracy of the Hounsfield unit (HU) for PE based on the hypothesis that acute thrombosis causes an increase in HU value on CT. Methods This research was a single-center, retrospective study. Patients presenting to the emergency department diagnosed with PE on CTPA were enrolled as the study group. Patients admitted to the same emergency department who were not diagnosed with PE and had noncontrast CT scans were included as the control group. A receiver operating curve was produced to determine the diagnostic accuracy of HU values in predicting PE. Results The study population (n=74) consisted of a study group (n=46) and a control group (n=28). The sensitivity and specificity of the HU value for predicting PE on thoracic CT were as follows: for the right main pulmonary artery, 61.5% and 96.4% at a value of 54.8 (area under the curve [AUC], 0.690); for the left main pulmonary artery, 65.0% and 96.4% at a value of 55.9 (AUC, 0.736); for the right interlobar artery, 44.4% and 96.4% at a value of 62.7 (AUC, 0.615); and for the left interlobar artery, 60.0% and 92.9% at a value of 56.7 (AUC, 0.736). Conclusion HU may exhibit high diagnostic specificity on CT for thrombi up to the interlobar level. An HU value exceeding 54.8 up to the interlobar level may raise suspicion of the presence of PE.
Citations
Citations to this article as recorded by
Hounsfield Unit Dynamics During CT-Guided Transthoracic Core Needle Biopsy as a Predictor of Malignant vs. Non-Malignant Thoracic Lesions Mustafa Yeşilyurt, Buğra Kerget, Özlem Küçükoğlu, Fahri Aydın, Alperen Aksakal, Adem Karaman, Fatih Alper British Journal of Hospital Medicine.2026;[Epub] CrossRef
Non-contrast CT of pulmonary embolus Yusuke Kimura, Kosuke Ishizuka, Kenya Ie, Chiaki Okuse BMJ Case Reports.2025; 18(10): e263888. CrossRef
The prognostic role of pulmonary artery thrombus density among patients with intermediate-risk pulmonary embolism Merve Osoydan Satici, Çagatay Nuhoglu, Banu Arslan, Nazim Cetinkaya, Celal Satici Emergency Radiology.2025; 33(3): 461. CrossRef
Objective Severe pulmonary embolism (PE) has a high mortality rate, which can be lowered by thrombolytic therapy (TT). However, full-dose TT is associated with major complications, including life-threatening bleeding. The aim of this study was to explore the efficacy and safety of extended, low-dose administration of tissue plasminogen activator (tPA) on in-hospital mortality and outcomes in massive PE.
Methods This was a single-center, prospective cohort trial at a tertiary university hospital. A total of 37 consecutive patients with massive PE were included. A peripheral intravenous infusion was used to administer 25 mg of tPA over 6 hours. The primary endpoints were in-hospital mortality, major complications, pulmonary hypertension, and right ventricular dysfunction. The secondary endpoints were 6-month mortality and pulmonary hypertension and right ventricular dysfunction 6 months after the PE.
Results The mean age of the patients was 68.76±14.54 years. The mean pulmonary artery systolic pressure (PASP; 56.51±7.34 mmHg vs. 34.16±2.81 mmHg, P<0.001) and right/left ventricle diameter (1.37±0.12 vs. 0.99±0.12, P<0.001) decreased significantly after TT. Tricuspid annular plane systolic excursion (1.43±0.33 cm vs. 2.07±0.27 cm, P<0.001), myocardial performance index (0.47±0.08 vs. 0.55±0.07, P<0.001), and systolic wave prime (9.6±2.8 vs. 15.3±2.6) increased significantly after TT. No major bleeding or stroke was observed. There was one in-hospital death and two additional deaths within 6 months. No cases of pulmonary hypertension were identified during follow-up.
Conclusion The results of this pilot study suggest that an extended infusion of low-dose tPA is a safe and effective therapy in patients with massive PE. This protocol was also effective in decreasing PASP and restoring right ventricular function.
Citations
Citations to this article as recorded by
2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults Mark A. Creager, Geoffrey D. Barnes, Jay Giri, Debabrata Mukherjee, William Schuyler Jones, Allison E. Burnett, Teresa Carman, Ana I. Casanegra, Lana A. Castellucci, Sherrell M. Clark, Mary Cushman, Kerstin de Wit, Jennifer M. Eaves, Margaret C. Fang, Jos JACC.2026; 87(13): 1626. CrossRef
2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines Mark A. Creager, Geoffrey D. Barnes, Jay Giri, Debabrata Mukherjee, William Schuyler Jones, Allison E. Burnett, Teresa Carman, Ana I. Casanegra, Lana A. Castellucci, Sherrell M. Clark, Mary Cushman, Kerstin de Wit, Jennifer M. Eaves, Margaret C. Fang, Jos Circulation.2026;[Epub] CrossRef
Personalised viscoelastometry-guided systemic thrombolysis for high- and intermediate-high-risk acute pulmonary embolism in the ICU: a single-centre randomised controlled interventional feasibility trial András Kállai, Anna Párkányi, Máté Berczi, Dalma Skultéti, János Domonkos Stubnya, Hanna Dóra Szász, Gergely Szombath, Adrienne Fehér, Zsolt Dániel Iványi, János Gál, János Fazakas Intensive Care Medicine Experimental.2026;[Epub] CrossRef
Kết quả ngắn hạn và trung hạn điều trị thuyên tắc động mạch phổi bằng thuốc Alteplase tại Viện Tim mạch, Bệnh viện Bạch Mai Nguyễn Mai Hương, Nguyễn Thị Thu Hương, Lê Hồng An, Tạ Mạnh Cường, Nguyễn Đức Hòa, Mai Thị Kim Liên Tạp chí Tim mạch học Việt Nam.2026;[Epub] CrossRef
Reduced-Dose Tenecteplase in High-Risk Pulmonary Embolism Jennifer Hammond, Dean Cataldo, Christopher Allison, Seth Kelly The Journal of Emergency Medicine.2025; 71: 67. CrossRef
Fibrinolytic uses in the emergency department: a narrative review Brit Long, William J. Brady, Michael Gottlieb The American Journal of Emergency Medicine.2025; 89: 85. CrossRef
Pulmonary Embolism: Unanswered Questions and Ongoing Evidence Gaps Omar Elmadhoun, Michael P. Merren, Patrick M. Wieruszewski, Juan G. Ripoll, Jeffrey Huang, Harish Ramakrishna Journal of Cardiothoracic and Vascular Anesthesia.2025; 39(9): 2498. CrossRef
Low-dose Systemic Tissue-type-plasminogen-activator Compared to Conventional Anti-coagulation for the Treatment of Intermediate-high Risk Pulmonary Embolism Alan De la Rosa, Adrian Rojas Murguia, Michael J. Brockman, Debabrata Mukherjee, Manu Rajachandran, Nils P. Nickel Cardiovascular & Hematological Disorders-Drug Targets.2025; 25(1): 46. CrossRef
Shock Index and Physiological Stress Index for reestratifying patients with intermediate-high risk pulmonary embolism Marcos Valiente Fernández, Amanda Lesmes González de Aledo, Francisco de Paula Delgado Moya, Isaías Martín Badía, Elena Álvaro Valiente, Nerea Blanco Otaegui, Pablo Risco Torres, Ignacio Saéz de la Fuente, Silvia Chacón Alves, Lidia Orejón García, María S Medicina Intensiva (English Edition).2024; 48(6): 309. CrossRef
Safety and Efficacy of Reduced-Dose Versus Full-Dose Alteplase for Acute Pulmonary Embolism: A Multicenter Observational Comparative Effectiveness Study* Roman Melamed, David M. Tierney, Ranran Xia, Caitlin S. Brown, Kristin C. Mara, Matthew Lillyblad, Abbey Sidebottom, Brandon M. Wiley, Ivan Khapov, Ognjen Gajic Critical Care Medicine.2024; 52(5): 729. CrossRef
Management of high-risk pulmonary embolism in the emergency department: A narrative review Samuel G. Rouleau, Scott D. Casey, Christopher Kabrhel, David R. Vinson, Brit Long The American Journal of Emergency Medicine.2024; 79: 1. CrossRef
Addressing the rising trend of high‐risk pulmonary embolism mortality: Clinical and research priorities Scott D. Casey, William B. Stubblefield, Dieuwke Luijten, Frederikus A. Klok, Lauren M. Westafer, David R. Vinson, Christopher Kabrhel Academic Emergency Medicine.2024; 31(3): 288. CrossRef
Shock Index and Physiological Stress Index for reestratifying patients with intermediate-high risk pulmonary embolism Marcos Valiente Fernández, Amanda Lesmes González de Aledo, Francisco de Paula Delgado Moya, Isaías Martín Badía, Elena Álvaro Valiente, Nerea Blanco Otaegui, Pablo Risco Torres, Ignacio Saéz de la Fuente, Silvia Chacón Alves, Lidia Orejón García, María S Medicina Intensiva.2024; 48(6): 309. CrossRef
Objective According to the 2019 European Society of Cardiology (ESC) guidelines on pulmonary embolism (PE), prognosis is calculated using the Pulmonary Embolism Severity Index (PESI), a complex score with debated validity, or simplified PESI (sPESI). We have developed and validated a new risk score for in-hospital mortality (IHM) of patients with PE in the emergency department.
Methods This retrospective, dual-center cohort study was conducted in the emergency departments of two third-level university hospitals. Patients aged >18 years with a contrast-enhanced computed tomography-confirmed PE were included. Clinical variables and laboratory tests were evaluated blindly to IHM. Multivariable logistic regression was performed to identify the new score’s predictors, and the new score was compared with the PESI, sPESI, and shock index.
Results A total of 1,358 patients were included in this study: 586 in the derivation cohort and 772 in the validation cohort, with a global 10.6% of IHM. The PATHOS scores were developed using independent variables to predict mortality: platelet count, age, troponin, heart rate, oxygenation, and systolic blood pressure. The PATHOS score showed good calibration and high discrimination, with an area under the receiver operating characteristics curve of 0.83 (95% confidence interval [CI], 0.77–0.89) in the derivation population and 0.74 (95% CI, 0.68–0.80) in the validation cohort, which is significantly higher than the PESI, sPESI, and shock index in both cohorts (P<0.01 for all comparisons).
Conclusion PATHOS is a simple and effective prognostic score for predicting IHM in patients with PE in an emergency setting.
Citations
Citations to this article as recorded by
Comparison of easy-to-use clinical prognostic models to identify low-risk normotensive patients with pulmonary embolism Manuel Gloor, Odile Stalder, Tobias Tritschler, Marie Méan, Nicolas Rodondi, Marc Righini, Drahomir Aujesky Journal of Thrombosis and Haemostasis.2026; 24(3): 1056. CrossRef
PATHOS–Lactate score: A novel prognostic tool for predicting in-hospital mortality in acute pulmonary embolism Ekrem Taha Sert, Kamil Kokulu, Oğuz Yürük, Emin Hüseyin Akar Heart & Lung.2026; 78: 102755. CrossRef
Prognostic Performance of the PATHOS Score Compared with CURB-65 and A-DROP in Emergency Department Patients with Community-acquired Pneumonia Kamil Kokulu, Ekrem Taha Sert Medical Bulletin of Haseki.2026; 64(2): 101. CrossRef
Comparative Prognostic Value of the Shock Index, Modified Shock Index, and Simplified Pulmonary Embolism Severity Index in Predicting Short-Term Outcomes in Patients with Acute Pulmonary Embolism Selim Değirmenci, Hasan Kara Archives of Current Medical Research.2026; 7(2): 268. CrossRef
External validation of the PE-SCORE for predicting early clinical deterioration in acute pulmonary embolism using real-world data Melis Efeoğlu Saçak, Arzu Denizbaşı Journal of Thrombosis and Thrombolysis.2026;[Epub] CrossRef
Performance of the PATHOS score in predicting in-hospital mortality in patients aged 65 years and older admitted to the intensive care unit from the emergency department Ekrem Taha Sert, Kamil Kokulu Cukurova Medical Journal.2025; 50(1): 99. CrossRef
Prognostic Impact of Albumin/Globulin and Lactate/Globulin Ratios Combined With sPESI and BOVA Scores in Pulmonary Embolism Mortality Abdullah Şen, Cahfer Güloğlu, Nikhat Kaura International Journal of Clinical Practice.2025;[Epub] CrossRef
The Hidden Signal: P Wave Morphology and In-Hospital Mortality in Acute Pulmonary Embolism Corina Cinezan, Alexandra Manuela Buzle, Maria Luiza Hiceag, Camelia Bianca Rus Diagnostics.2025; 15(20): 2636. CrossRef
The prognostic value of HALP score and sPESI in predicting in-hospital mortality in patients with pulmonary thromboembolism Mahmut Yaman, Murat Orak, Hasan Mansur Durgun, Veysi Tekin, Şilan Göger Ülgüt, Sema Belek, Berçem Tugay Günel, Mehmet Üstündağ, Cahfer Güloğlu, Ercan Gündüz Postgraduate Medical Journal.2024; 101(1191): 60. CrossRef
A new model for estimating in-hospital mortality in patients with pulmonary embolism: PATHOS score Halil ALIŞKAN, Mazlum KILIÇ Anatolian Current Medical Journal.2023; 5(3): 237. CrossRef
Objective We aimed to determine the effect of fibrinolytic therapy on hemodynamic parameters at 4 hours after treatment and bleeding complications in patients with intermediate- and high-risk pulmonary embolism.
Methods This single-center, retrospective, cohort study included patients with intermediate- and high-risk pulmonary embolism treated with fibrinolytics. Their demographic and clinical characteristics, complications, and vital signs at the initiation of and 4 hours after fibrinolytic therapy were evaluated. The primary outcome was the change in the patients’ vital signs at 4 hours after fibrinolytic therapy, compared by the Mann-Whitney U-test.
Results Seventy-nine patients were included in this study. The systolic and diastolic blood pressures of the high-risk group at 4 hours after fibrinolytic therapy were higher than those at the initiation of fibrinolytic therapy (80 mmHg vs. 99 mmHg, P = 0.029; 49 mmHg vs. 67 mmHg, P = 0.011, respectively). In the intermediate-risk group, the oxygen saturation increased (94% vs. 96%, P = 0.004) and pulse rate decreased (104 beats/min vs. 91 beats/min, P < 0.001).
Conclusion Blood pressure at 4 hours after fibrinolytic therapy increased in patients with high-risk pulmonary embolism. Also, oxygen saturation and pulse rate improved in intermediate-risk patients.
Objective Recently, a novel score for risk stratification of patients with pulmonary embolism (PE)—the HOPPE score—was derived. We aimed to externally validate the HOPPE score in emergency department-diagnosed PE, using SpO2 as a surrogate for PaO2—the modified HOPPE score.
Methods Retrospective observational study of adult patients with an emergency department diagnosis of PE was performed. Data collected included demographics, co-morbidities, clinical features, electrocardiogram and test results, in-hospital mortality and non-fatal major adverse clinical events (MACE; survived cardiac arrest, cardiogenic shock or thrombolysis administration). The primary outcome of interest was clinical performance of the modified HOPPE score for inhospital mortality and the composite outcome of in-hospital death and MACE. A secondary outcome was comparison of predictive performance between the modified HOPPE score and the simplified Pulmonary Embolism Severity Index score.
Results Two hundred and six patients were studied (median age 61, 55% female). There were no deaths or MACE in patients with a low risk modified HOPPE score of 0 to 6 (0%; 95% confidence interval, 0% to 1.8%). Negative predictive value of a low risk score was 100% (95% confidence interval, 92.2% to 100%) for in-hospital mortality and for the composite of in-hospital mortality or MACE. The modified HOPPE score had similar predictive performance to the simplified Pulmonary Embolism Severity Index score with an area under the curve of 0.88 vs. 0.80 for the composite outcome of in-hospital mortality or MACE (P=0.052). Twenty-eight percent of the patients were classified as low risk and potentially suitable for management as outpatients.
Conclusion The modified HOPPE score showed good clinical performance. Prospective validation is warranted.
Citations
Citations to this article as recorded by
Serum Lactate, an Independent Prognostic Marker in Normotensive Patients With Acute Pulmonary Thromboembolism Rodica Lucia Avram, Monica Mariana Băluță, Caterina Delcea, Anna Maria Andronescu, Elena Lechea, Gabriela Vladu, Alexandru Cristian Nechita Romanian Journal of Cardiology.2022; 32(4): 182. CrossRef
The diagnosis or exclusion of pulmonary embolism (PE) remains challenging for emergency physicians. Symptoms can be vague or non-existent, and the clinical presentation shares features with many other common diagnoses. Diagnostic testing is complicated, as biomarkers, like the D-dimer, are frequently false positive, and imaging, like computed tomography pulmonary angiography, carries risks of radiation and contrast dye exposure. It is therefore incumbent on emergency physicians to be both vigilant and thoughtful about this diagnosis. In recent years, several advances in treatment have also emerged. Novel, direct-acting oral anticoagulants make the outpatient treatment of low risk PE easier than before. However, the spectrum of PE severity varies widely, so emergency physicians must be able to risk-stratify patients to ensure the appropriate disposition. Finally, PE response teams have been developed to facilitate rapid access to advanced therapies (e.g., catheter directed thrombolysis) for patients with high-risk PE. This review will discuss the clinical challenges of PE diagnosis, risk stratification and treatment that emergency physicians face every day.
Citations
Citations to this article as recorded by
Natural Language Processing in Clinical Quality Measures of Diagnostic Performance: Learnings from Three Case Reports Abigail Evans, Meridith Eastman, Patricia C. Dykes, Barbara E. Jones, John Sather, Jeffrey Geppert The Joint Commission Journal on Quality and Patient Safety.2026; 52(4): 154. CrossRef
Comparative Prognostic Value of the Shock Index, Modified Shock Index, and Simplified Pulmonary Embolism Severity Index in Predicting Short-Term Outcomes in Patients with Acute Pulmonary Embolism Selim Değirmenci, Hasan Kara Archives of Current Medical Research.2026; 7(2): 268. CrossRef
Inflammation as a Cornerstone in the Early Diagnosis and Treatment of Pulmonary Embolism Alexandru Covaciu, Emanuel Cojocariu, Elena Bobescu, Valentina Benza, Nicoleta Cojocaru, Georgiana Laura Stefănescu, Madalina Ivascu, Lilia Aida Mahjoub, Andreea Amalia Tomulescu, Christian Gabriel Strempel, Horatiu Rus Journal of Cardiovascular Emergencies.2026; 12(2): 68. CrossRef
Association of Serum Oncostatin M with In-Hospital Mortality in Acute Pulmonary Embolism: A Prospective Cohort Study Orhun Girgin, Mustafa Burak Sayhan, Eray Çeliktürk, Satuk Buğra Han Bozatlı, Suat Erdoğan, Esin Seçgin Sayhan Bratislava Medical Journal.2026;[Epub] CrossRef
Effect of detection method for right ventricular strain on subsequent interventions for acute pulmonary embolism Kyle E. Chang, Drew A. Birrenkott, Mads Dam Lyhne, Paul S. Jansson, Nora Horick, Christiana K. Prucnal, Gregory A. Peters, Timothy M. Matthews, Karsten Stannek, Eun Sang Lee, Isabel T. Dhar, Sophie H. Flomenbaum, Tyleah M. Brown, Matthew F. Freitas, Jesse Canadian Journal of Respiratory, Critical Care, and Sleep Medicine.2026; : 1. CrossRef
Impact of coincident lower extremity deep vein thrombosis on symptomatic and incidental pulmonary embolism outcomes. A single-center prospective cohort study Steven Callori, Waldemar Wysokinsk, Danielle Vlazny, Damon E. Houghton, David A. Froehling, David O. Hodge, Ana I. Casanegra, Robert D. McBane Journal of Thrombosis and Haemostasis.2025; 23(4): 1260. CrossRef
Hampton’s Hump—A Rare Radiological Feature in Patients with Pulmonary Embolism in a Single-Center Study Kinga Kubiak, Katarzyna Bazylewicz-Zakrzewska, Wojciech Poncyljusz Journal of Clinical Medicine.2025; 14(6): 1900. CrossRef
Venous lactate as a tool for the Risk-Stratification of patients with acute pulmonary embolism: A retrospective cohort study Eun Sang Lee, Kyle E. Chang, Christiana K. Prucnal, Karsten Stannek, Paige Koetter, William B. Stubblefield, Isabel Dhar, Drew A. Birrenkott, Grace Wang, Timothy M. Matthews, Nora Horick, Gregory A. Peters, Tyleah Brown, Christopher Kabrhel Clinical Biochemistry.2025; 138: 110942. CrossRef
Diagnosis and Management of Pulmonary Emboli Due to Atrial Masses in Two Children Mohammad Mahdavi, Hamidreza Pouraliakbar, Alireza Yaghoubi, Golnar M. Hejri Pediatric Pulmonology.2025;[Epub] CrossRef
Unmet Needs and Future Direction for Pulmonary Embolism Interventions Harshvardhan Zala, Huseyin Emre Arman, Saurav Chatterjee, Ankur Kalra Cardiac Electrophysiology Clinics.2025; 17(3): 387. CrossRef
A Novel Tool for Predicting an Abnormal Echocardiogram in Patients with Pulmonary Embolism: The PEACE Score Nour Al Jalbout, Irene Ma, Hamid Shokoohi, Kathleen McFadden, Christopher Kabrhel, Nicholas Giordano, Andrew Liteplo The Journal of Emergency Medicine.2024; 66(4): e403. CrossRef
Pulmonary embolism: Thrombus-in-transit Natalie T. Truong, Patrick B. Hinfey JEM Reports.2024; 3(1): 100071. CrossRef
POCUS for Thrombus: Emphasizing the Importance of Initial Point-of-Care Ultrasound in the Management of Pulmonary Thromboembolism Menkeoma Laura Okoli, Poonam Rao, Siima Kavuma, Ravi Vijay Bulusu, Shafik Hanna-Moussa, Khashayar Vahdat Cureus.2024;[Epub] CrossRef
Triple Threat: A Case Presentation of Pulmonary Embolism With Diabetic Ketoacidosis and Lower Respiratory Tract Infection Varsha S Shinde, Yash Dixit Cureus.2024;[Epub] CrossRef
Bioinformatics analysis of potential common pathogenic mechanisms for COVID-19 and venous thromboembolism Ling Zhang, Jing Qin, Peiwu Li Cytokine.2024; 181: 156682. CrossRef
Клінічний випадок тромбоемболії легеневої артерії у хворого з негоспітальною пневмонією M. P. Boichak, I. M. Lyovkin, E. P. Olkhovska, N. V. Nitsak, Yu. Ya. Kotyk Ukrainian Journal of Military Medicine.2024; 5(2): 137. CrossRef
Pulmonary Embolism and Right Ventricular Dysfunction: Mechanism and Management Ogbonnaya N Ajah Cureus.2024;[Epub] CrossRef
Unmet Needs and Future Direction for Pulmonary Embolism Interventions Harshvardhan Zala, Huseyin Emre Arman, Saurav Chatterjee, Ankur Kalra Interventional Cardiology Clinics.2023; 12(3): 399. CrossRef
The Utilisation of Computed Tomography Pulmonary Angiography in a Regional Victorian Emergency Department Ali Uthuman, Tae H Kim, Subatharshini Sountharalingam Cureus.2023;[Epub] CrossRef
Approach to pulmonary embolism: A clinical care pathway Mohamed Toufic El Hussein, Ali Bayrouti Journal of the American Association of Nurse Practitioners.2022; 34(1): 172. CrossRef
A Feasibility Study on the Identification of Potential Biomarkers in Pulmonary Embolism Using Proteomic Analysis Fredrik Granholm, Dan Bylund, Ganna Shevchenko, Sara B. Lind, Anders E. Henriksson Clinical and Applied Thrombosis/Hemostasis.2022;[Epub] CrossRef
Diagnosis and treatment of acute pulmonary embolism: A single center experience Ayşe ERTEKİN, Aydın BALCI, Erhan BOZKURT, Emre ATAY, Ramazan Sami AKTAŞ Acta Medica Alanya.2022; 6(1): 87. CrossRef
An efficient and fast multi-band focused bioimpedance solution with EIT-based reconstruction for pulmonary embolism assessment: a simulation study from massive to segmental blockage Duc Nguyen Minh, Luong Duong Trong, Alistair McEwan Physiological Measurement.2022; 43(2): 025003. CrossRef
Streamlining Patient Management of Suspected COVID-19 Patients in the Emergency Department: Incorporation of Pulmonary CT Angiography into the Triaging Algorithm Benedikt M. Schaarschmidt, David Fistera, Yan Li, Margarete Konik, Johannes Haubold, Johannes Grueneisen, Oliver Witzke, Michael Forsting, Carola Holzner, Lale Umutlu Diagnostics.2022; 12(5): 1183. CrossRef
Clot In Transit in a Patient with Protein S Deficiency Simon Kashfi, Mohamed Farhan Nasser, Aron Soleiman, Sapna Sharma, Venkata Sandeep Koripalli, Shorabh Sharma European Journal of Case Reports in Internal Medicine.2022;[Epub] CrossRef
Pulmonary Artery Filling Defects in COVID‐19 Patients Revealed Using CT Pulmonary Angiography: A Predictable Complication? Arnaldo Scardapane, Laura Villani, Davide Fiore Bavaro, Francesca Passerini, Amato Antonio Stabile Ianora, Nicola Maria Lucarelli, Gioacchino Angarano, Piero Portincasa, Vincenzo Ostilio Palmieri, Annalisa Saracino, Cristiana Corsi BioMed Research International.2021;[Epub] CrossRef
Post-acute COVID-19 syndrome Ani Nalbandian, Kartik Sehgal, Aakriti Gupta, Mahesh V. Madhavan, Claire McGroder, Jacob S. Stevens, Joshua R. Cook, Anna S. Nordvig, Daniel Shalev, Tejasav S. Sehrawat, Neha Ahluwalia, Behnood Bikdeli, Donald Dietz, Caroline Der-Nigoghossian, Nadia Liyan Nature Medicine.2021; 27(4): 601. CrossRef
Upregulation of Inflammatory Cytokines in Pulmonary Embolism Using Biochip-Array Profiling Emily Bontekoe, Yevgeniy Brailovsky, Debra Hoppensteadt, Jack Bontekoe, Fakiha Siddiqui, Joshua Newman, Omer Iqbal, Trent Reed, Jawed Fareed, Amir Darki Clinical and Applied Thrombosis/Hemostasis.2021;[Epub] CrossRef
Contemporary Catheter-Based Treatment Options for Management of Acute Pulmonary Embolism Maninder Singh, Irfan Shafi, Parth Rali, Joseph Panaro, Vladimir Lakhter, Riyaz Bashir Current Treatment Options in Cardiovascular Medicine.2021;[Epub] CrossRef
COVID‐19‐related coagulopathy: A review of pathophysiology and pharmaceutical management Mahdi Kohansal Vajari, Mahsa Shirin, Atieh Pourbagheri‐Sigaroodi, Mohammad Esmaeil Akbari, Hassan Abolghasemi, Davood Bashash Cell Biology International.2021; 45(9): 1832. CrossRef
Role of Chest CT in COVID-19 Nagina Malguria, Li-Hsiang Yen, Tony Lin, Amira Hussein, Elliot K. Fishman Journal of Clinical Imaging Science.2021; 11: 30. CrossRef
Present aspects of thrombolytic therapy of pulmonary artery thromboembolism Y. V. Ovchinnikov, M. V. Zelenov, V. S. Polovinka, E. V. Kryukov Clinical Medicine (Russian Journal).2021; 99(1): 6. CrossRef
Liver injury in COVID-19: Detection, pathogenesis, and treatment Yue Cai, Li-Ping Ye, Ya-Qi Song, Xin-Li Mao, Li Wang, Yan-Zhi Jiang, Wei-Tao Que, Shao-Wei Li World Journal of Gastroenterology.2021; 27(22): 3022. CrossRef
Diagnostic accuracy of ultrasound-guided core needle biopsy versus incisional biopsy in soft tissue sarcoma: an institutional experience Miroslava Cernakova, Gerhard M. Hobusch, Gabriele Amann, Philipp T. Funovics, Reinhard Windhager, Joannis Panotopoulos Scientific Reports.2021;[Epub] CrossRef
Post-covid condition in adults and children Dina V. Baimukhambetova, Anastasia O. Gorina, Mikhail A. Rumyantsev, Anastasia A. Shikhaleva, Yasmin A. El-Taravi, Elena D. Bondarenko, Valentina A. Kapustina, Daniil B. Munblit PULMONOLOGIYA.2021; 31(5): 562. CrossRef
Surgical pulmonary embolectomy on VA-ECMO Rachel Steinhorn, Adam A. Dalia, Edward A. Bittner, Marvin G. Chang Respiratory Medicine Case Reports.2021; : 101551. CrossRef
Post-COVID syndrome: prevalence, organ pathogenesis and routes of correction. A systematic review S. G. Kanorskii Kuban Scientific Medical Bulletin.2021; 28(6): 90. CrossRef
Prevalencia de embolia pulmonar en pacientes con infección por COVID-19, abril-diciembre de 2020 Tatiana Suárez Poveda, Johan Sebastián Lopera Valle, Vanesa Andrea Vasco Lopez Revista colombiana de radiología.2021; 32(4): 5634. CrossRef
Wells and Geneva Scores Are Not Reliable Predictors of Pulmonary Embolism in Critically Ill Patients: A Retrospective Study Adriana M. Girardi, Renata S. Bettiol, Tiago S. Garcia, Gustavo L. H. Ribeiro, Édison Moraes Rodrigues, Marcelo B. Gazzana, Tatiana H. Rech Journal of Intensive Care Medicine.2020; 35(10): 1112. CrossRef
Analysis of Partial Thromboplastin Times in Patients With Pulmonary Embolism During the First 48 Hours of Anticoagulation With Unfractionated Heparin Christiana K. Prucnal, Paul S. Jansson, Erin Deadmon, Rachel P. Rosovsky, Hui Zheng, Christopher Kabrhel, Michael S. Runyon Academic Emergency Medicine.2020; 27(2): 117. CrossRef
Percutaneous Thrombectomy in Emergency Department Patients with Pulmonary Embolism: The FLARE ED Sub-study Wissam A. Jaber, Christopher Kabrhel, Kenneth Rosenfield, Thomas Tu, Kenneth Ouriel, Victor F. Tapson The Journal of Emergency Medicine.2020; 58(2): 175. CrossRef
Acute Pulmonary Embolism in Patients with COVID-19 at CT Angiography and Relationship to d-Dimer Levels Ian Léonard-Lorant, Xavier Delabranche, François Séverac, Julie Helms, Coralie Pauzet, Olivier Collange, Francis Schneider, Aissam Labani, Pascal Bilbault, Sébastien Molière, Pierre Leyendecker, Catherine Roy, Mickaël Ohana Radiology.2020; 296(3): E189. CrossRef
Initial Experience with Non-Sternotomy Minimally Invasive Pulmonary Embolectomy with Thoracoscopic Assistance John M. Fallon, Jason W. Greenberg, Luvika Gupta, Omar M. Lattouf Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery.2020; 15(2): 180. CrossRef
COVID-19 and the endothelium F. Jung, A. Krüger-Genge, R.P. Franke, F. Hufert, J.-H. Küpper Clinical Hemorheology and Microcirculation.2020; 75(1): 7. CrossRef
Efficacy of Computed Tomography Pulmonary Angiography as Non-invasive Imaging Biomarker for Risk Stratification of Acute Pulmonary Embolism Mahmoud M. Higazi, Rasha Abdel Raouf Abdel Fattah, Elham Abdelhady Abdelghany, Hosny S. Abdel Ghany Journal of Clinical Imaging Science.2020; 10: 49. CrossRef
Differential diagnostic factors of type 1 and type 2 myocardial infarction in patients with elevated cardiac troponin levels Youngho Seo, Jinhui Paik, Seunglyul Shin, Ahjin Kim, Soo Kang Clinical and Experimental Emergency Medicine.2020; 7(3): 213. CrossRef
Awareness and management of pulmonary embolism among physicians in China: a nationwide cross-sectional study Meng Zhang, Yun-Xia Zhang, Zhu Zhang, Jing Wang, Xiang Shao, Wan-Mu Xie, Jun Wan, Zhen-Guo Zhai, Chen Wang Journal of Thrombosis and Thrombolysis.2019; 47(3): 436. CrossRef
Lessons from a patient with cardiac arrest due to massive pulmonary embolism as the initial presentation of Wilms tumor: a case report and literature review Atsuna Fukuda, Takeshi Isoda, Naoya Sakamoto, Keisuke Nakajima, Tetsuya Ohta BMC Pediatrics.2019;[Epub] CrossRef
Pentraxin-3 Levels Relate to the Wells Score and Prognosis in Patients with Acute Pulmonary Embolism Haotian Yang, Jun Zhang, Ying Huan, Yawei Xu, Rong Guo Disease Markers.2019; 2019: 1. CrossRef
Pulmonary embolism response teams: Purpose, evidence for efficacy, and future research directions Rachel Rosovsky, Ken Zhao, Akhilesh Sista, Belinda Rivera‐Lebron, Christopher Kabrhel Research and Practice in Thrombosis and Haemostasis.2019; 3(3): 315. CrossRef
The Role of Interventional Radiology in the Treatment of Acute Thrombosis and Chronic Veno-Occlusive Disease in Children and Adolescents Anne E. Gill, Kavita N. Patel Seminars in Roentgenology.2019; 54(4): 324. CrossRef
CURRENT VIEW ON ANTICOAGULANT AND THROMBOLYTIC TREATMENT OF ACUTE PULMONARY EMBOLISM G. G. Taradin, G. A. Ignatenko, N. T. Vatutin, I. V. Kanisheva The Russian Archives of Internal Medicine.2019; 9(5): 348. CrossRef
A Brief Review of Cardiovascular Diseases, Associated Risk Factors and Current Treatment Regimes Gagan D. Flora, Manasa K. Nayak Current Pharmaceutical Design.2019; 25(38): 4063. CrossRef
Multicenter Implementation of a Novel Management Protocol Increases the Outpatient Treatment of Pulmonary Embolism and Deep Vein Thrombosis Christopher Kabrhel, Rachel Rosovsky, Christopher Baugh, Jean Connors, Benjamin White, Nicholas Giordano, Jasmine Torrey, Erin Deadmon, Blair Alden Parry, Sean Hagan, Hui Zheng, Yonathan Freund Academic Emergency Medicine.2019; 26(6): 657. CrossRef
Neurological recovery from multiple cardiac arrests due to acute massive pulmonary embolism managed by cardiopulmonary resuscitation and extracorporeal membrane oxygenation Hussein Algahtani, Mohammed Azzam, Amr S. Albanna, Bader Shirah Cardiovascular Revascularization Medicine.2018; 19(1): 120. CrossRef
Diagnostic utility of an age‐specific cut‐off for d‐dimer for pulmonary embolism assessment when used with various pulmonary embolism risk scores Imogen Ackerly, Sharon Klim, James McFarlane, Anne‐Maree Kelly Internal Medicine Journal.2018; 48(4): 465. CrossRef
The impact of a multi-specialty team for high risk pulmonary embolism on resident and fellow education Ayman Elbadawi, Colin Wright, Dhwani Patel, Yu Lin Chen, Justin Mazzillo, Pamela Cameron, Geoffrey D Barnes, Scott J Cameron Vascular Medicine.2018; 23(4): 372. CrossRef
Management of Low-Risk Pulmonary Embolism Ebtesam Attaya Islam, Richard E. Winn, Victor Test Clinics in Chest Medicine.2018; 39(3): 561. CrossRef
Estudo Transversal dos Óbitos Provocados por Tromboembolismo Pulmonar Necropsiados no Instituto Médico Legal de Belo Horizonte, 2008–2011 Leonardo Santos Bordoni, Nayara Moreira da Cunha, Thais Yoko Ferreira Koga, Polyanna Helena Coelho Bordoni Brazilian Journal of Forensic Sciences, Medical Law and Bioethics.2017; 6(2): 194. CrossRef
Pulmonary Embolism in Children Ahmar Urooj Zaidi, Kelley K. Hutchins, Madhvi Rajpurkar Frontiers in Pediatrics.2017;[Epub] CrossRef
Dilemmas in the management of venous thromboembolism in older patients Musfira Shakeel, Jecko Thachil British Journal of Hospital Medicine.2017; 78(10): 552. CrossRef
Endovascular treatment of pulmonary embolism: Selective review of available techniques John L Nosher, Arjun Patel, Sugeet Jagpal, Christopher Gribbin, Vyacheslav Gendel World Journal of Radiology.2017; 9(12): 426. CrossRef
Objective Introduction of target specific anticoagulants and recent guidelines encourage outpatient management of low risk patients with venous thromboembolism. We describe hospital admission rates over time for patients presenting to US emergency departments (EDs) with deep vein thrombosis (DVT) and pulmonary embolism (PE) and estimate the proportion of low-risk PE patients who could potentially be managed as outpatients.
Methods We performed a structured analysis of the National Hospital Ambulatory Medical Care Survey (a nationally representative weighted sampling of US ED visits) database for the years 2006–2010 including all adult patients with a primary diagnosis of DVT or PE. Simplified pulmonary embolus scoring index (sPESI) scores were determined in patients with PE to identify low risk patients.
Results There were an estimated 652,000 and 394,000 ED visits for DVT and PE over the 5-year period (0.17%). Mean (SE) age was 59 (1.3), 50% were female, and 40% were > 65 years. Admission rates for DVT and PE were 52% and 90% respectively with no significant changes over time. In patients with DVT, predictors for admission were age (odds ratio, 1.03 per year of age [95% confidence interval, 1.01 to 1.05]) and race (odds ratio, 4.1 [95% confidence interval, 0.9 to 19.8] for Hispanics and 2.9 [1.2 to 7.4] for Blacks). Of all ED patients with PE, 51% were low risk based on sPESI scores.
Conclusion Admission rates for DVT and PE have remained high and unchanged, especially with PE, minorities, and in older patients. Based on sPESI scores, up to half of PE patients might be eligible for early discharge or outpatient therapy.
Citations
Citations to this article as recorded by
Initiation of an emergency department discharge pathway for low-risk patients with venous thromboembolism: Factors impact real-world practice William B Stubblefield, James Barclay, Jesse O Wrenn, Doug Conway, Scott Nelson, Quinn S Wells, Dario Giuse, Zhao Zuo, Alexandra M Baird, Tyler Barrett, Shi Huang, Karen Beauchamp, Alan B Storrow, Sean P Collins, Joshua A Beckman Vascular Medicine.2026;[Epub] CrossRef
Association between the simplified Pulmonary Embolism Severity Index (sPESI) score and hospitalization in emergency department patients diagnosed with pulmonary embolism Pranav Tandon, Cameron Thompson, Karen Li, Shelley L. McLeod, Kerstin de Wit, Keerat Grewal Thrombosis Research.2025; 245: 109234. CrossRef
Anticoagulation for patients discharged from the emergency department with venous thromboembolism Pranav Tandon, Cameron Thompson, Karen Li, Shelley L. McLeod, Kerstin de Wit, Keerat Grewal The American Journal of Emergency Medicine.2025; 93: 182. CrossRef
Qualitative experience implementing an emergency department-based outpatient low-risk pulmonary embolism management pathway S Nabeel Hyder, Valerie Gavrila, Anthony Cuttitta, Colin Greineder, Geoffrey D Barnes Vascular Medicine.2025; 30(3): 326. CrossRef
Clinical predictors of hospital admission in low-risk pulmonary embolism: a retrospective cohort study Kwadwo O. Bonsu, Stephanie W. Young, Tiffany. A. Lee, Hai V. Nguyen, Rufaro S. Chitsike Hospital Practice.2025;[Epub] CrossRef
Outpatient Management of Pulmonary Embolism Patients with Direct Oral Anticoagulants: A Systematic Review Alvina S. Khachatryan, Denis V. Rylnikov, Sevara A. Mirakhmedova, Evgeny I. Seliverstov, Evgeny S. An, Igor A. Zolotukhin Journal of Clinical Medicine.2025; 14(24): 8931. CrossRef
Trends in Discharge Rates for Acute Pulmonary Embolism in U.S. Emergency Departments Nathan W. Watson, Brett J. Carroll, Anna Krawisz, Alec Schmaier, Eric A. Secemsky Annals of Internal Medicine.2024; 177(2): 134. CrossRef
Long-term outcomes and predictors of mortality in patients with pulmonary embolism undergoing catheter-directed thrombolysis: a 10-year retrospective study Sushan Gupta, Tessabella Magliochetti Cammarata, Daniel Cheah, Nellie Haug, Talha Bin Farooq, Vishesh Paul, Danish Thameem Current Problems in Cardiology.2024; 49(5): 102471. CrossRef
Development and Validation of a Natural Language Processing Model to Identify Low-Risk Pulmonary Embolism in Real Time to Facilitate Safe Outpatient Management Krunal D. Amin, Elizabeth Hope Weissler, William Ratliff, Alexander E. Sullivan, Tara A. Holder, Cathleen Bury, Samuel Francis, Brent Jason Theiling, Bradley Hintze, Michael Gao, Marshall Nichols, Suresh Balu, William Schuyler Jones, Mark Sendak Annals of Emergency Medicine.2024; 84(2): 118. CrossRef
Charlson and Elixhauser Comorbidity Indices for Prediction of Mortality and Hospital Readmission in Patients With Acute Pulmonary Embolism Alexander O’Hara, Jacob Pozin, Mohammed Abourahma, Ryan Gigstad, Danny Torres, Benji Knapp, Bulent Kantarcioglu, Jawed Fareed, Amir Darki Clinical and Applied Thrombosis/Hemostasis.2024;[Epub] CrossRef
Association of IVCF use with mortality and intracranial hemorrhage in patients with selected cancers and brain metastasis Renata Abrahão, Ann Brunson, Vaibhav Kumar, Anjlee Mahajan, Nigel S. Key, Theresa Keegan, Ted Wun Blood Vessels, Thrombosis & Hemostasis.2024; 1(2): 100011. CrossRef
Implementation of a transition of care pathway for low-risk patients presenting to the emergency department with venous thromboembolism Alexandra Moran Baird, Aaron W. Aday, Alexander E. Sullivan, Tiffany Street, Tyler W. Barrett, Sean P. Collins, William B. Stubblefield, Megan M. Shifrin DNP, Joshua A. Beckman Journal of Vascular Nursing.2024; 42(3): 208. CrossRef
Mortality Outcomes with Tenecteplase Versus Alteplase in the Treatment of Massive Pulmonary Embolism Luke R. Murphy, Adam Singer, Brandon Okeke, Krishna Paul, Matthew Talbott, Dietrich Jehle The Journal of Emergency Medicine.2024; 67(5): e432. CrossRef
Systemic Estrogen Therapy and Thrombosis: A Call for Individualized Clinical Decision Making in the Acute Care Setting Valentina Restrepo, Kelsey Martin, Layla Van Doren Clinical Therapeutics.2024; 46(12): 949. CrossRef
Epidemiology of deep venous thrombosis in US emergency departments during an 8-year period Eric Moyer, Kyle Bernard, Michael Gottlieb Clinical and Experimental Emergency Medicine.2024; 12(2): 132. CrossRef
Emergency Department Management of Acute Venous Thromboembolism in Patients With Obesity With Intravenous Unfractionated Heparin and Anti-Xa Monitoring Dion J. Tyler, Kelsea A. Caruso, Abbie E. Lyden, Katrina M. Karpowitsch Journal of Pharmacy Practice.2023; 36(3): 588. CrossRef
Point-of-care ultrasound: impact on emergency department length of stay for suspected lower extremity DVT Yonathan Estrella, Alexander Bronzo, Luke Fey, Aaron Ryoo, Samuel Ayala, Maya Lin, Theodore Gaeta Emergency Radiology.2023; 30(2): 203. CrossRef
Bilateral Emboli and Highest Heart Rate Predict Hospitalization of Emergency Department Patients With Acute, Low-Risk Pulmonary Embolism Scott D. Casey, Lara Zekar, Madeline J. Somers, Lauren M. Westafer, Mary E. Reed, David R. Vinson Annals of Emergency Medicine.2023; 82(3): 369. CrossRef
Barriers and Facilitators to the Outpatient Management of Low-risk Pulmonary Embolism From the Emergency Department Lauren M. Westafer, Erica Jessen, Michael Zampi, Eric Boccio, Scott D. Casey, Peter K. Lindenauer, David R. Vinson Annals of Emergency Medicine.2023; 82(3): 381. CrossRef
Comparing predictive performance of pulmonary embolism risk stratification tools for acute clinical deterioration Anthony J. Weekes, Jaron D. Raper, Dasia Esener, Jillian Davison, Jeremy S. Boyd, Christopher Kelly, Jason T. Nomura, Alyssa M. Thomas, Kathryn Lupez, Carly A. Cox, Patrick M. Ockerse, Stephen Leech, Jakea Johnson, Eric Abrams, Kathleen Murphy, Nathaniel JACEP Open.2023; 4(3): e12983. CrossRef
Oral anticoagulation therapy in the treatment of pulmonary thromboembolism Maja Omčikus, Ivan Milivojević Galenika Medical Journal.2023; 2(5): 62. CrossRef
Predictive Value for Increased Red Blood Cell Distribution Width in Unprovoked Acute Venous Thromboembolism at the Emergency Department Cláudia Febra, Verónica Spinu, Filipa Ferreira, Victor Gil, Rui Maio, Deborah Penque, Ana Macedo Clinical and Applied Thrombosis/Hemostasis.2023;[Epub] CrossRef
Mechanical thrombectomy is associated with shorter length of hospital stay and lower readmission rates compared with conservative therapy for acute submassive pulmonary embolism: a propensity-matched analysis Zain M. Khazi, Justin Pierce, Shahrzad Azizaddini, Ryan Davis, Ambarish P. Bhat Diagnostic and Interventional Radiology.2023; 29(6): 794. CrossRef
Impact of an Institutional Clinical Pathway on Emergency Physicians’ Stated Preferences in Treating Patients with Low-Risk Pulmonary Embolism Arvin Radfar Akhavan, Alex O’Brien-Lambert, Nick Postiglione, Anneliese M. Schleyer, Marie Vrablik, M. Kennedy Hall Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine.2023; 22(4): 120. CrossRef
Effect of Prognostic Guided Management of Patients With Acute Pulmonary Embolism According to the European Society of Cardiology Risk Stratification Model David Jiménez, Carmen Rodríguez, Beatriz Pintado, Andrea Pérez, Luis Jara-Palomares, Raquel López-Reyes, Pedro Ruiz-Artacho, Alberto García-Ortega, Behnood Bikdeli, José Luis Lobo Frontiers in Cardiovascular Medicine.2022;[Epub] CrossRef
Can right ventricular assessments improve triaging of low risk pulmonary embolism? Jaron D. Raper, Alyssa M. Thomas, Kathryn Lupez, Carly A. Cox, Dasia Esener, Jeremy S. Boyd, Jason T. Nomura, Jillian Davison, Patrick M. Ockerse, Stephen Leech, Jakea Johnson, Eric Abrams, Kathleen Murphy, Christopher Kelly, Nathaniel S. O'Connell, Antho Academic Emergency Medicine.2022; 29(7): 835. CrossRef
Increasing rates of venous thromboembolism among hospitalised patients with inflammatory bowel disease: a nationwide analysis Adam S. Faye, Kate E. Lee, John Dodson, Joshua Chodosh, David Hudesman, Feza Remzi, Jason D. Wright, Alexander M. Friedman, Aasma Shaukat, Timothy Wen Alimentary Pharmacology & Therapeutics.2022; 56(7): 1157. CrossRef
Outpatient Treatment of Low‐risk Pulmonary Embolism in the Era of Direct Oral Anticoagulants: A Systematic Review Brandon C. Maughan, Lisa Frueh, Marian S. McDonagh, Bryan Casciere, Jeffrey A. Kline, Mark Courtney Academic Emergency Medicine.2021; 28(2): 226. CrossRef
Outpatient Management of Patients Following Diagnosis of Acute Pulmonary Embolism Lauren M. Westafer, Meng‐Shiou Shieh, Penelope S. Pekow, Mihaela S. Stefan, Peter K. Lindenauer Academic Emergency Medicine.2021; 28(3): 336. CrossRef
Provider perceptions of extended venous thromboembolism prophylaxis for hospitalized medically ill patients Jenny Hiatt, Sara R. Vazquez, Daniel M. Witt Thrombosis Update.2021; 2: 100034. CrossRef
Arterial and venous thromboembolic complications of COVID-19 detected by CT angiogram and venous duplex ultrasound Edison Lee, Adam Krajewski, Cynthia Clarke, David O’Sullivan, Timothy Herbst, Steven Lee Emergency Radiology.2021; 28(3): 469. CrossRef
Outpatient treatment of emergency department patients diagnosed with venous thromboembolism William B. Stubblefield, Jeffrey A. Kline Postgraduate Medicine.2021; 133(sup1): 11. CrossRef
SGEM#323: Mama I’m comin’ home—For outpatient treatment of a pulmonary embolism Corey Heitz, Kirsty Challen, William K. Milne Academic Emergency Medicine.2021; 28(11): 1325. CrossRef
Monotherapy Anticoagulation to Expedite Home Treatment of Patients Diagnosed With Venous Thromboembolism in the Emergency Department: A Pragmatic Effectiveness Trial Jeffrey A. Kline, David H. Adler, Naomi Alanis, Joseph R. Bledsoe, Daniel M. Courtney, James P. d’Etienne, Deborah B. Diercks, John S. Garrett, Alan E. Jones, David C. Mackenzie, Troy Madsen, Andrew J. Matuskowitz, Bryn E. Mumma, Kristen E. Nordenholz, Ju Circulation: Cardiovascular Quality and Outcomes.2021;[Epub] CrossRef
Development and validation of a prognostic tool: Pulmonary embolism short-term clinical outcomes risk estimation (PE-SCORE) Anthony J. Weekes, Jaron D. Raper, Kathryn Lupez, Alyssa M. Thomas, Carly A. Cox, Dasia Esener, Jeremy S. Boyd, Jason T. Nomura, Jillian Davison, Patrick M. Ockerse, Stephen Leech, Jakea Johnson, Eric Abrams, Kathleen Murphy, Christopher Kelly, H. James N PLOS ONE.2021; 16(11): e0260036. CrossRef
A clinical decision framework to guide the outpatient treatment of emergency department patients diagnosed with acute pulmonary embolism or deep vein thrombosis: Results from a multidisciplinary consensus panel Christopher Kabrhel, David R. Vinson, Alice Marina Mitchell, Rachel P. Rosovsky, Anna Marie Chang, Jackeline Hernandez‐Nino, Stephen J. Wolf JACEP Open.2021; 2(6): e12588. CrossRef
Comparison of inpatient admission rates of patients treated with apixaban vs. warfarin for venous thromboembolism in the emergency department Steven Deitelzweig, Patrick Hlavacek, Jack Mardekian, Lisa Rosenblatt, Cristina Russ, Kenneth Tuell, Melissa Lingohr-Smith, Jay Lin, Jennifer D Guo Hospital Practice.2020; 48(1): 41. CrossRef
Home vs hospital treatment of low-risk venous thromboembolism: a systematic review and meta-analysis Rasha Khatib, Stephanie Ross, Sean Alexander Kennedy, Ivan D. Florez, Thomas L. Ortel, Robby Nieuwlaat, Ignacio Neumann, Daniel M. Witt, Sam Schulman, Veena Manja, Rebecca Beyth, Nathan P. Clark, Wojtek Wiercioch, Holger J. Schünemann, Yuqing Zhang Blood Advances.2020; 4(3): 500. CrossRef
New insights on patient-related risk factors for venous thromboembolism in patients with solid organ cancers Aditya Kotecha, Deepa Raghavan, Sumeet K. Yadav, Anupam A. Sule, Camelia Arsene International Journal of Hematology.2020; 112(4): 477. CrossRef
External validation of the modified HOPPE score to predict low risk pulmonary embolism suitable for early discharge Kajal Patel, Sharon Klim, Peter Ritchie, Ieuan Johns, Anne-Maree Kelly Clinical and Experimental Emergency Medicine.2020; 7(2): 107. CrossRef
Diagnosis and Treatment of Deep Vein Thrombosis in the Emergency Department: Results of an Italian Nominal Group Technique Study Aldo Salvi, Cinzia Nitti, Andrea Fabbri, Paolo Groff, Enrico Giuseppe Ruggiero, Giancarlo Agnelli Clinical and Applied Thrombosis/Hemostasis.2020;[Epub] CrossRef
Healthcare resource use in XALIA: A subgroup analysis of a non-interventional study of rivaroxaban versus standard anticoagulation for deep vein thrombosis Lorenzo G. Mantovani, Sylvia Haas, Reinhold Kreutz, Kerstin Folkerts, Martin Gebel, Danja Monje, Jonas Schneider, Martin van Eickels, Kurtulus Sahin, Elizabeth Zell, Walter Ageno, Alexander G.G. Turpie European Journal of Internal Medicine.2019; 61: 29. CrossRef
Reducing the hospital burden associated with the treatment of pulmonary embolism W. Frank Peacock, Ada.J. Singer Journal of Thrombosis and Haemostasis.2019; 17(5): 720. CrossRef
Venous thromboembolism in the emergency department: A survey of current best practice awareness in physicians and nurses in China Wen-hua Zhou, Jian-qiang He, Shi-gong Guo, Joseph Walline, Xiao-ying Liu, Li-yuan Tian, Hua-dong Zhu, Xue-zhong Yu, Yi Li World Journal of Emergency Medicine.2019; 10(1): 5. CrossRef
Multicenter Implementation of a Novel Management Protocol Increases the Outpatient Treatment of Pulmonary Embolism and Deep Vein Thrombosis Christopher Kabrhel, Rachel Rosovsky, Christopher Baugh, Jean Connors, Benjamin White, Nicholas Giordano, Jasmine Torrey, Erin Deadmon, Blair Alden Parry, Sean Hagan, Hui Zheng, Yonathan Freund Academic Emergency Medicine.2019; 26(6): 657. CrossRef
A one year audit of patients with venous thromboembolism presenting to a tertiary hospital in Johannesburg, South Africa Lara Nicole Goldstein, Ming-Tung Wu African Journal of Emergency Medicine.2018; 8(1): 12. CrossRef
Emergency Department Discharge of Pulmonary Embolus Patients W. Frank Peacock, Craig I. Coleman, Deborah B. Diercks, Samuel Francis, Christopher Kabrhel, Catherine Keay, Jeffrey A. Kline, Jacob Manteuffel, Peter Wildgoose, Jim Xiang, Adam J. Singer, Brian C. Hiestand Academic Emergency Medicine.2018; 25(9): 995. CrossRef
Systematic Review of Real-World Studies Evaluating Characteristics Associated With or Programs Designed to Facilitate Outpatient Management of Deep Vein Thrombosis Erin R. Weeda, Sofia Butt Clinical and Applied Thrombosis/Hemostasis.2018; 24(9_suppl): 301S. CrossRef
Anticoagulant therapies for acute venous thromboembolism: a comparison between those discharged directly from the emergency department versus hospital in two Canadian cities Tammy J Bungard, Bruce Ritchie, Jennifer Bolt, William M Semchuk BMJ Open.2018; 8(10): e022063. CrossRef
The creation and implementation of an outpatient pulmonary embolism treatment protocol Christopher Kabrhel, Rachel Rosovsky, Christopher Baugh, Blair Alden Parry, Erin Deadmon, Charlotte Kreger, Nicholas Giordano Hospital Practice.2017; 45(3): 123. CrossRef
Discharge or admit? Emergency department management of incidental pulmonary embolism in patients with cancer: a retrospective study Srinivas R. Banala, Sai-Ching Jim Yeung, Terry W. Rice, Cielito C. Reyes-Gibby, Carol C. Wu, Knox H. Todd, W. Frank Peacock, Kumar Alagappan International Journal of Emergency Medicine.2017;[Epub] CrossRef
Multicenter Trial of Rivaroxaban for Early Discharge of Pulmonary Embolism From the Emergency Department (MERCURY PE): Rationale and Design Adam J. Singer, Jim Xiang, Christopher Kabrhel, Gino J. Merli, Charles Pollack, Victor F. Tapson, Peter Wildgoose, W. Frank Peacock, Christopher R. Carpenter Academic Emergency Medicine.2016; 23(11): 1280. CrossRef
Massive pulmonary embolism (MPE) with hemodynamic instability is a clinical condition with a poor prognosis and high mortality rates. There are no definitive treatment options for cardiac arrest due to MPE. A 52-year-old female presented at our emergency department with cardiac arrest, and a 62-year-old female presented after achieving return of spontaneous circulation of cardiac arrest from a local hospital, respectively. In each case, computed tomographic pulmonary angiography after return of spontaneous circulation demonstrated heavy burdens of pulmonary embolism in the pulmonary arteries. We immediately started therapeutic hypothermia and fibrinolytic therapy. They were transferred to the thoracic surgery and cardiology departments respectively, and then discharged with a cerebral performance categories scale score of 1. In summary, we report two cases of out-of-hospital cardiac arrest due to MPE in which fibrinolytic therapy was successfully combined with therapeutic hypothermia.
First
Prev
