Disposition of emergency department patients with acute pulmonary embolism after ambulance arrival

• Published in: Journal of the American College of Emergency Physicians Open 2023-12, Vol.4 (6), p.e13068-n/a
• Main Authors: Rouleau, Samuel G., Campbell, Aidan R., Huang, Jie, Reed, Mary E., Vinson, David R.
• Format: Article
• Language: English
• Subjects: ambulance transport; Cohort analysis; Emergency medical care; Emergency services; Ethnicity; Hospitalization; Hypotheses; Mortality; Outpatient care facilities; outpatient management; Patients; pulmonary embolism; Pulmonary embolisms; Thromboembolism; Variables; Vital signs
• ISSN: 2688-1152; 2688-1152
• DOI: 10.1002/emp2.13068

Objective Most outpatients with pulmonary embolism (PE) are diagnosed in the emergency department (ED). The relationship between means of arrival, site of diagnosis, and disposition in ED patients with PE is unknown. We compared discharge home between patients arriving by emergency medical services (EMS) and those arriving by other means. Within the EMS cohort, we compared those with a recent PE diagnosis in the outpatient clinic setting to those who were diagnosed with PE in the ED. Methods This study was a secondary analysis of a retrospective cohort that included all adult, non‐pregnant ED patients treated for acute PE across 21 community EDs from January 2013 to April 2015. The primary outcome was discharge home within 24 h of ED registration; we also examined mortality. We described associations with patient arrival method and other patient characteristics. Results Among 2996 ED patient encounters with acute PE, 644 (21.5%) arrived by EMS. This group had a lower frequency of discharge (9.2% vs 26.4%) and higher 30‐day all‐cause mortality (8.7% vs 3.1%) than their counterparts (p