Donadini, Marco Paolo; Mumoli, Nicola; Fenu, Patrizia; Pomero, Fulvio; Re, Roberta; Palmiero, Gerardo; Spadafora, Laura; Mazzi, Valeria; Grittini, Alessandra; Bertù, Lorenza; Aujesky, Drahomir; Dentali, Francesco; Ageno, Walter; Squizzato, Alessandro (2024). The Clinical Impact of the Pulmonary Embolism Severity Index on the Length of Hospital Stay of Patients with Pulmonary Embolism: A Randomized Controlled Trial. Diagnostics, 14(7) MDPI 10.3390/diagnostics14070776
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BACKGROUND
The Pulmonary Embolism Severity Index (PESI) is an extensively validated prognostic score, but impact analyses of the PESI on management strategies, outcomes and health care costs are lacking. Our aim was to assess whether the adoption of the PESI for patients admitted to an internal medicine ward has the potential to safely reduce the length of hospital stay (LOS).
METHODS
We carried out a multicenter randomized controlled trial, enrolling consecutive adult outpatients diagnosed with acute PE and admitted to an internal medicine ward. Within 48 h after diagnosis, the treating physicians were randomized, for every patient, to calculate and report the PESI in the clinical record form on top of the standard of care (experimental arm) or to continue routine clinical practice (standard of care). The ClinicalTrials.gov identifier is NCT03002467.
RESULTS
This study was prematurely stopped due to slow recruitment. A total of 118 patients were enrolled at six internal medicine units from 2016 to 2019. The treating physicians were randomized to the use of the PESI for 59 patients or to the standard of care for 59 patients. No difference in the median LOS was found between the experimental arm (8, IQR 6-12) and the standard-of-care arm (8, IQR 6-12) (p = 0.63). A pre-specified secondary analysis showed that the LOS was significantly shorter among the patients who were treated with DOACs (median of 8 days, IQR 5-11) compared to VKAs or heparin (median of 9 days, IQR 7-12) (p = 0.04).
CONCLUSIONS
The formal calculation of the PESI in the patients already admitted to internal medicine units did not impact the length of hospital stay.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine |
UniBE Contributor: |
Aujesky, Drahomir |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2075-4418 |
Publisher: |
MDPI |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
15 Apr 2024 10:06 |
Last Modified: |
15 Apr 2024 10:15 |
Publisher DOI: |
10.3390/diagnostics14070776 |
PubMed ID: |
38611689 |
Uncontrolled Keywords: |
Pulmonary Embolism Severity Index length of hospital stay pulmonary embolism |
BORIS DOI: |
10.48350/195943 |
URI: |
https://boris.unibe.ch/id/eprint/195943 |
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