Rate and duration of hospitalization for deep vein thrombosis and pulmonary embolism in real-world clinical practice

Abstract

Background: Current guidelines recommend initial treatment with anticoagulants at home in patients with acute deep vein thrombosis (DVT) and in patients with low-risk pulmonary embolism (PE) with adequate home circumstances. However, most of the patients with acute venous thromboembolism (VTE) are currently hospitalized regardless of their risk of short-term complications.

Aim of the study: To assess the proportion of outpatients with acute VTE initially treated in hospitals, to assess the mean duration of hospitalization, and to identify predictors for in-hospital or home treatment.

Methods: Data of Italian patients enrolled in the RIETE registry from January 2006 to December 2013 were included.

Results: Altogether 766 PE and 1,452 isolated DVT were included. Among PE patients, mean PESI score was 84 points (SD 35), and 56% of patients had a low-risk PESI score (<85). In all, 53.7% of DVT and 17.0% of PE were entirely treated at home, and 38.2% of DVT patients and 19.9% of PE patients were hospitalized for ≤5 days. On multivariate analysis, low PESI score was not independently associated with the hospitalization of PE patients.

Conclusions: One in every two patients with DVT and five in every six with PE are still hospitalized.

Keywords: Hospitalization; treatment; venous thromboembolism.