巴可公司% 0期刊文章%斯特凡诺Schmidtman %n, Irene %A Ageno, Walter %A Anušić, Toni %A Bauersachs, Rupert M. %A Becattini, Cecilia %A Bernardi, Enrico %A Beyer-Westendorf, Jan %A Bonacchini, Luca %A Brachmann, Johannes %A Christ, Michael %A Czihal, Michael %A Duerschmied, Daniel %A Empen, Klaus %A Espinola-Klein, Christine %A Ficker, Joachim H. %A Fonseca, Cândida %A Genth-Zotz, Sabine %A Jiménez, David %A Harjola, Veli-Pekka %A Held, Matthias %A Iogna Prat, Lorenzo %A Lange, Tobias J. %A Lankeit, Mareike %A Manolis, Athanasios %A Meyer, Andreas %A Münzel, Thomas %A Mustonen, Pirjo %A Rauch-Kroehnert, Ursula %A Ruiz-Artacho, Pedro %A Schellong, Sebastian %A Schwaiblmair, Martin %A Stahrenberg, Raoul %A Valerio, Luca %A Westerweel, Peter E. %A Wild, Philipp S. %A Konstantinides, Stavros V. %T Survival and quality of life after early discharge in low-risk pulmonary embolism %D 2021 %R 10.1183/13993003.02368-2020 %J European Respiratory Journal %P 2002368 %V 57 %N 2 %X 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 %U //www.qdcxjkg.com/content/erj/57/2/2002368.full.pdf