RT期刊文章SR电子T1生存和quality of life after early discharge in low-risk pulmonary embolism JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 2002368 DO 10.1183/13993003.02368-2020 VO 57 IS 2 A1 Barco, Stefano A1 Schmidtmann, Irene A1 Ageno, Walter A1 Anušić, Toni A1 Bauersachs, Rupert M. A1 Becattini, Cecilia A1 Bernardi, Enrico A1 Beyer-Westendorf, Jan A1 Bonacchini, Luca A1 Brachmann, Johannes A1 Christ, Michael A1 Czihal, Michael A1 Duerschmied, Daniel A1 Empen, Klaus A1 Espinola-Klein, Christine A1 Ficker, Joachim H. A1 Fonseca, Cândida A1 Genth-Zotz, Sabine A1 Jiménez, David A1 Harjola, Veli-Pekka A1 Held, Matthias A1 Iogna Prat, Lorenzo A1 Lange, Tobias J. A1 Lankeit, Mareike A1 Manolis, Athanasios A1 Meyer, Andreas A1 Münzel, Thomas A1 Mustonen, Pirjo A1 Rauch-Kroehnert, Ursula A1 Ruiz-Artacho, Pedro A1 Schellong, Sebastian A1 Schwaiblmair, Martin A1 Stahrenberg, Raoul A1 Valerio, Luca A1 Westerweel, Peter E. A1 Wild, Philipp S. A1 Konstantinides, Stavros V. YR 2021 UL //www.qdcxjkg.com/content/57/2/2002368.abstract AB 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