Clinical safety of home treatment for pulmonary embolism: a multicenter registry study of the Asian population

TL;DR

This study found that home treatment for pulmonary embolism in Japanese patients is as safe as in-hospital treatment within 30 days.

Contribution

The study provides new evidence on the clinical safety of home-based treatment for pulmonary embolism in an Asian population.

Findings

Home and in-hospital treatments showed similar 30-day clinical outcomes in Japanese patients with PE.

The primary composite outcome occurred in 3% of home-treated patients and 6% of in-hospital patients.

Individual components of the primary outcome were also comparable between the two groups.

Abstract

The short-term safety of home-based management of pulmonary embolism (PE) in Asian patients remains unclear.

The aim of the study was to assess the 30-day clinical safety of home-based treatment compared with in-hospital treatment in Japanese patients with PE.

In this multicenter retrospective study, we enrolled consecutive patients diagnosed with acute PE from the Heart and Vascular Disease Outcome Study in Saga and Kyushu Region-venous thromboembolism registry, performed in the Saga prefecture, Japan, between 2015 and 2024. Among the 641 registered patients, 104 and 537 were treated at home and in the hospital, respectively. After performing 1:1 propensity score matching, 208 patients were analyzed. The primary composite outcome was 30-day PE-related death, aggravation of venous thromboembolism, and bleeding events. Bleeding events were defined based on the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries criteria as moderate/severe.

After propensity score matching, the mean ± SD patient age was 66 ± 14 years, and 45% of the patients were men. In total, 72% of the patients had deep vein thrombosis, and 81% were treated with a direct oral anticoagulant. The primary composite outcome occurred in 3 patients (3%) in the home treatment group and in 6 patients (6%) in the in-hospital treatment group, with no significant difference between the 2 groups (log-rank test, P = .69). Individual components of the primary composite outcome were also comparable.

The risk of PE-related events and bleeding in Japanese patients with PE treated at home was comparable to that of patients who received in-hospital treatment.

•The safety of home-based management of PE in Asian patients remains unclear.•We compared the 30-day clinical events of home-based vs in-hospital care in Japanese patients with PE.•After propensity score matching, the incidence of clinical events was similar between the 2 settings.•Home-based management of PE was clinically safe in this multicenter Japanese cohort.

The safety of home-based management of PE in Asian patients remains unclear.

We compared the 30-day clinical events of home-based vs in-hospital care in Japanese patients with PE.

After propensity score matching, the incidence of clinical events was similar between the 2 settings.

Home-based management of PE was clinically safe in this multicenter Japanese cohort.

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