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Hospitalization is less common in ambulatory patients with acute pulmonary embolism diagnosed before emergency department referral than after arrival

Academic Emergency Medicine Jul 09, 2020

Vinson DR, Bath H, Huang J, et al. - Researchers conducted a retrospective cohort study of ambulatory adults with acute objectively confirmed pulmonary embolism (PE) across 21 emergency departments (EDs) in an integrated health care system in order to characterize this population. Outpatients with diagnostic pulmonary imaging in the 12 hours prior to ED arrival (the clinic‐based cohort) were compared with those receiving imaging for PE only after ED arrival. They identified 2,352 eligible ED patients with acute PE; of these, 344 (14.6%) had a clinic‐based diagnosis. Observations revealed that ambulatory outpatients with acute PE are commonly diagnosed before ED arrival. PE Severity Index classification and likelihood to be hospitalized were lower for this cohort vs their counterparts with an ED‐based diagnosis: 80.8% vs. 92.0%. Persistence of the inverse association with hospitalization was observed after adjusting for the above patient characteristics. 

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