TY - T1的生存和生活质量early discharge in low-risk pulmonary embolism JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.02368-2020 VL - 57 IS - 2 SP - 2002368 AU - Barco, Stefano AU - Schmidtmann, Irene AU - Ageno, Walter AU - Anušić, Toni AU - Bauersachs, Rupert M. AU - Becattini, Cecilia AU - Bernardi, Enrico AU - Beyer-Westendorf, Jan AU - Bonacchini, Luca AU - Brachmann, Johannes AU - Christ, Michael AU - Czihal, Michael AU - Duerschmied, Daniel AU - Empen, Klaus AU - Espinola-Klein, Christine AU - Ficker, Joachim H. AU - Fonseca, Cândida AU - Genth-Zotz, Sabine AU - Jiménez, David AU - Harjola, Veli-Pekka AU - Held, Matthias AU - Iogna Prat, Lorenzo AU - Lange, Tobias J. AU - Lankeit, Mareike AU - Manolis, Athanasios AU - Meyer, Andreas AU - Münzel, Thomas AU - Mustonen, Pirjo AU - Rauch-Kroehnert, Ursula AU - Ruiz-Artacho, Pedro AU - Schellong, Sebastian AU - Schwaiblmair, Martin AU - Stahrenberg, Raoul AU - Valerio, Luca AU - Westerweel, Peter E. AU - Wild, Philipp S. AU - Konstantinides, Stavros V. Y1 - 2021/02/01 UR - //www.qdcxjkg.com/content/57/2/2002368.abstract N2 - Introduction Early discharge of patients with acute low-risk pulmonary embolism requires validation by prospective trials with clinical and quality-of-life outcomes.Methods The multinational Home Treatment of Patients with Low-Risk Pulmonary Embolism with the Oral Factor Xa Inhibitor Rivaroxaban (HoT-PE) single-arm management trial investigated early discharge followed by ambulatory treatment with rivaroxaban. The study was stopped for efficacy after the positive results of the predefined interim analysis at 50% of the planned population. The present analysis includes the entire trial population (576 patients). In addition to 3-month recurrence (primary outcome) and 1-year overall mortality, we analysed self-reported disease-specific (Pulmonary Embolism Quality of Life (PEmb-QoL) questionnaire) and generic (five-level five-dimension EuroQoL (EQ-5D-5L) scale) quality of life as well as treatment satisfaction (Anti-Clot Treatment Scale (ACTS)) after pulmonary embolism.Results The primary efficacy outcome occurred in three (0.5%, one-sided upper 95% CI 1.3%) patients. The 1-year mortality was 2.4%. The mean±sd PEmb-QoL decreased from 28.9±20.6% at 3 weeks to 19.9±15.4% at 3 months, a mean change (improvement) of −9.1% (p<0.0001). Improvement was consistent across all PEmb-QoL dimensions. The EQ-5D-5L was 0.89±0.12 at 3 weeks after enrolment and improved to 0.91±0.12 at 3 months (p<0.0001). Female sex and cardiopulmonary disease were associated with poorer disease-specific and generic quality of life; older age was associated with faster worsening of generic quality of life. The ACTS burden score improved from 40.5±6.6 points at 3 weeks to 42.5±5.9 points at 3 months (p<0.0001).Conclusions Our results further support early discharge and ambulatory oral anticoagulation for selected patients with low-risk pulmonary embolism. Targeted strategies may be necessary to further improve quality of life in specific patient subgroups.The results of the complete primary outcome analysis of the HoT-PE study, as well as long-term mortality and quality-of-life data, support early discharge and ambulatory oral anticoagulation with rivaroxaban for selected patients with acute low-risk PE https://bit.ly/32qX0mu ER -