{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T22:53:07Z","timestamp":1785019987674,"version":"3.55.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T00:00:00Z","timestamp":1720742400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Aims<\/jats:title>\n                  <jats:p>Home treatment is considered safe in acute pulmonary embolism (PE) patients selected by a validated triage tool (e.g. simplified PE severity index score or Hestia rule), but there is uncertainty regarding the applicability in underrepresented subgroups. The aim was to evaluate the safety of home treatment by performing an individual patient-level data meta-analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Ten prospective cohort studies or randomized controlled trials were identified in a systematic search, totalling 2694 PE patients treated at home (discharged within 24\u2005h) and identified by a predefined triage tool. The 14- and 30-day incidences of all-cause mortality and adverse events (combined endpoint of recurrent venous thromboembolism, major bleeding, and\/or all-cause mortality) were evaluated. The relative risk (RR) for 14- and 30-day mortalities and adverse events is calculated in subgroups using a random effects model.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The 14- and 30-day mortalities were 0.11% [95% confidence interval (CI) 0.0\u20130.24, I2 = 0) and 0.30% (95% CI 0.09\u20130.51, I2 = 0). The 14- and 30-day incidences of adverse events were 0.56% (95% CI 0.28\u20130.84, I2 = 0) and 1.2% (95% CI 0.79\u20131.6, I2 = 0). Cancer was associated with increased 30-day mortality [RR 4.9; 95% prediction interval (PI) 2.7\u20139.1; I2 = 0]. Pre-existing cardiopulmonary disease, abnormal troponin, and abnormal (N-terminal pro\u2013)B-type natriuretic peptide [(NT-pro)BNP] at presentation were associated with an increased incidence of 14-day adverse events [RR 3.5 (95% PI 1.5\u20137.9, I2 = 0), 2.5 (95% PI 1.3\u20134.9, I2 = 0), and 3.9 (95% PI 1.6\u20139.8, I2 = 0), respectively], but not mortality. At 30 days, cancer, abnormal troponin, and abnormal (NT-pro)BNP were associated with an increased incidence of adverse events [RR 2.7 (95% PI 1.4\u20135.2, I2 = 0), 2.9 (95% PI 1.5\u20135.7, I2 = 0), and 3.3 (95% PI 1.6\u20137.1, I2 = 0), respectively].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The incidence of adverse events in home-treated PE patients, selected by a validated triage tool, was very low. Patients with cancer had a three- to five-fold higher incidence of adverse events and death. Patients with increased troponin or (NT-pro)BNP had a three-fold higher risk of adverse events, driven by recurrent venous thromboembolism and bleeding.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehae378","type":"journal-article","created":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T07:25:37Z","timestamp":1720769137000},"source":"Crossref","is-referenced-by-count":4,"title":["Safety of treating acute pulmonary embolism at home: an individual patient data meta-analysis"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4776-0587","authenticated-orcid":false,"given":"Dieuwke","family":"Luijten","sequence":"first","affiliation":[{"name":"Department of Medicine\u2014Thrombosis and Hemostasis, Leiden University Medical Center , Albinusdreef 2, 2333 ZA Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9529-1255","authenticated-orcid":false,"given":"Delphine","family":"Douillet","sequence":"additional","affiliation":[{"name":"Emergency Department, CHU Angers , Angers , France"},{"name":"UNIV Angers, UMR MITOVASC INSERM 1083\u2014CNRS 6015, Equipe CARME, SFR ICAT , Angers , France"},{"name":"F-CRIN, INNOVTE , Saint-Etienne , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5192-8368","authenticated-orcid":false,"given":"Kim","family":"Luijken","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University , Utrecht , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9161-7521","authenticated-orcid":false,"given":"Cecile","family":"Tromeur","sequence":"additional","affiliation":[{"name":"F-CRIN, INNOVTE , Saint-Etienne , France"},{"name":"D\u00e9partement de M\u00e9decine Interne et Pneumologie, Universit\u00e9 de Bretagne Occidentale, INSERM U1304-GETBO, Centre Hospitalo-Universitaire de Brest , F 29200 Brest , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4544-9501","authenticated-orcid":false,"given":"Andrea","family":"Penaloza","sequence":"additional","affiliation":[{"name":"F-CRIN, INNOVTE , Saint-Etienne , France"},{"name":"Emergency Department, Cliniques Universitaires Saint-Luc , Brussels , Belgium"},{"name":"UCLouvain , Brussels , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2312-1625","authenticated-orcid":false,"given":"Olivier","family":"Hugli","sequence":"additional","affiliation":[{"name":"Emergency Department, University Hospital of Lausanne and University of Lausanne , Lausanne , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3970-2670","authenticated-orcid":false,"given":"Drahomir","family":"Aujesky","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern , Bern , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2618-347X","authenticated-orcid":false,"given":"Stefano","family":"Barco","sequence":"additional","affiliation":[{"name":"Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University , Mainz , Germany"},{"name":"Department of Angiology, University Hospital Zurich , Zurich , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3005-2878","authenticated-orcid":false,"given":"Joseph R","family":"Bledsoe","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Intermountain Healthcare , Salt Lake City, UT , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle E","family":"Chang","sequence":"additional","affiliation":[{"name":"Center for Vascular Emergencies, Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School , Boston, MA , USA"},{"name":"School of Medicine, California University of Science and Medicine , Colton, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1855-8032","authenticated-orcid":false,"given":"Francis","family":"Couturaud","sequence":"additional","affiliation":[{"name":"F-CRIN, INNOVTE , Saint-Etienne , France"},{"name":"D\u00e9partement de M\u00e9decine Interne et Pneumologie, Universit\u00e9 de Bretagne Occidentale, INSERM U1304-GETBO, Centre Hospitalo-Universitaire de Brest , F 29200 Brest , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1543-5731","authenticated-orcid":false,"given":"Paul L","family":"den Exter","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Thrombosis and Hemostasis, Leiden University Medical Center , Albinusdreef 2, 2333 ZA Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3547-7373","authenticated-orcid":false,"given":"Carme","family":"Font","sequence":"additional","affiliation":[{"name":"Medical Oncology Department, Hospital Clinic de Barcelona , Barcelona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1423-5348","authenticated-orcid":false,"given":"Menno V","family":"Huisman","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Thrombosis and Hemostasis, Leiden University Medical Center , Albinusdreef 2, 2333 ZA Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Jimenez","sequence":"additional","affiliation":[{"name":"Respiratory Department and Medicine Department, Ramon y Cajal Hospital and Alcal\u00e1 University (IRYCIS), CIBER de Enfermedades Respiratorias (CIBERES) , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8699-7176","authenticated-orcid":false,"given":"Christopher","family":"Kabrhel","sequence":"additional","affiliation":[{"name":"Center for Vascular Emergencies, Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey A","family":"Kline","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Wayne State University School of Medicine , Detroit, MI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6359-7279","authenticated-orcid":false,"given":"Stavros","family":"Konstantinides","sequence":"additional","affiliation":[{"name":"Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University , Mainz , Germany"},{"name":"Department of Cardiology, Democritus University of Thrace , Alexandroupolis , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6520-1597","authenticated-orcid":false,"given":"Thijs","family":"van Mens","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Thrombosis and Hemostasis, Leiden University Medical Center , Albinusdreef 2, 2333 ZA Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2265-1221","authenticated-orcid":false,"given":"Remedios","family":"Otero","sequence":"additional","affiliation":[{"name":"Pneumology Department, Hospital Universitario Virgen del Roc\u00edo-IBIS-US_CIBERES , Seville , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W Frank","family":"Peacock","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Baylor College of Medicine, Ben Taub General Hospital , Houston, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1633-8391","authenticated-orcid":false,"given":"Olivier","family":"Sanchez","sequence":"additional","affiliation":[{"name":"F-CRIN, INNOVTE , Saint-Etienne , France"},{"name":"University Paris Cit\u00e9, INSERM UMR-S 1140 Innovative Therapies in Haemostasis , Paris , France"},{"name":"Pneumology Department and Intensive Care, H\u00f4pital Europ\u00e9en Georges Pompidou, APHP , Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3817-1414","authenticated-orcid":false,"given":"William B","family":"Stubblefield","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Vanderbilt University Medical Center , Nashville, TN , 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