{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T20:11:05Z","timestamp":1762459865571,"version":"3.37.3"},"reference-count":11,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003The Hestia criteria can be used to select pulmonary embolism (PE) patients for outpatient treatment. The subjective Hestia criterion \u201cmedical\/social reason for admission\u201d allows the treating physician to consider any patient-specific circumstances in the final management decision. It is unknown how often and why this criterion is scored.<\/jats:p><jats:p>\n          Methods\u2003This is a patient-level post hoc analysis of the combined Hestia and Vesta studies. The main outcomes were the frequency of all scored Hestia items in hospitalized patients and the explicit reason for scoring the subjective criterion. Hemodynamic parameters and computed tomography-assessed right ventricular (RV)\/left ventricular (LV) ratio of those only awarded with the subjective criterion were compared with patients treated at home.<\/jats:p><jats:p>\n          Results\u2003From the 1,166 patients screened, data were available for all 600 who were hospitalized. Most were hospitalized to receive oxygen therapy (45%); 227 (38%) were only awarded with the subjective criterion, of whom 51 because of \u201cintermediate to intermediate-high risk PE.\u201d Compared with patients with intermediate risk PE (RV\/LV ratio\u2009&gt;\u20091.0) treated at home (179\/566, 32%), hospitalized patients with only the subjective criterion had a higher mean RV\/LV ratio (mean difference +0.30, 95% confidence interval [CI] 0.19\u20130.41) and a higher heart rate (+18\/min, 95% CI 10\u201325). No relevant differences were observed for other hemodynamic parameters.<\/jats:p><jats:p>\n          Conclusion\u2003The most frequent reason for hospital admission was oxygen therapy. In the decision to award the subjective criterion as sole argument for admission, the severity of the RV overload and resulting hemodynamic response of the patient was taken into account rather than just abnormal RV\/LV ratio.<\/jats:p>","DOI":"10.1055\/s-0040-1713170","type":"journal-article","created":{"date-parts":[[2020,7,12]],"date-time":"2020-07-12T22:37:50Z","timestamp":1594593470000},"page":"1217-1220","source":"Crossref","is-referenced-by-count":2,"title":["Reasons for Hospitalization of Patients with Acute Pulmonary Embolism Based on the Hestia Decision Rule"],"prefix":"10.1055","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3753-5565","authenticated-orcid":false,"given":"Stephan V.","family":"Hendriks","sequence":"additional","affiliation":[{"name":"Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands"},{"name":"Department of Internal Medicine, Haga Teaching Hospital, The Hague, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul L.","family":"den Exter","sequence":"additional","affiliation":[{"name":"Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wendy","family":"Zondag","sequence":"additional","affiliation":[{"name":"Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rolf","family":"Brouwer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Reinier de Graaff Gasthuis, Delft, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michiel","family":"Eijsvogel","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco J.","family":"Grootenboers","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Amphia Hospital, Breda, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura M.","family":"Faber","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Rode Kruis Hospital, Beverwijk, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roxanne","family":"Heller-Baan","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Ikazia Hospital, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herman M. A.","family":"Hofstee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Haaglanden Medical Center, The Hague, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Iglesias del Sol","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Alrijne Hospital, Leiderdorp, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marieke J. H. A.","family":"Kruip","sequence":"additional","affiliation":[{"name":"Department of Haematology, Erasmus University Medical Center, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert T. A.","family":"Mairuhu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Haga Teaching Hospital, The Hague, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian F.","family":"Melissant","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Spaarne Hospital, Hoofddorp, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henny G.","family":"Peltenburg","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Groene Hart Hospital, Gouda, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel A.","family":"van de Ree","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Diakonessenhuis, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik H.","family":"Sern\u00e9","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, VU Medical Center, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Menno V.","family":"Huisman","sequence":"additional","affiliation":[{"name":"Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9961-0754","authenticated-orcid":false,"given":"Frederikus A.","family":"Klok","sequence":"additional","affiliation":[{"name":"Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the Hestia\/Vesta investigators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,6,28]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1093\/eurheartj\/ehz405","article-title":"2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS)","volume":"41","author":"S V Konstantinides","year":"2020","journal-title":"Eur Heart J"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1097\/MCP.0000000000000512","article-title":"Home treatment of acute pulmonary embolism: state of the art in 2018","volume":"24","author":"S J van der Wall","year":"2018","journal-title":"Curr Opin Pulm Med"},{"issue":"08","key":"ref3","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1111\/j.1538-7836.2011.04388.x","article-title":"Outpatient treatment in patients with acute pulmonary embolism: the Hestia Study","volume":"9","author":"W Zondag","year":"2011","journal-title":"J Thromb Haemost"},{"issue":"08","key":"ref4","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1164\/rccm.201512-2494OC","article-title":"Efficacy and safety of outpatient treatment based on the Hestia clinical decision rule with or without N-terminal pro-brain natriuretic peptide testing in patients with acute pulmonary embolism. 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