Articles producció científica> Medicina i Cirurgia

Randomised controlled trial of a prognostic assessment and management pathway to reduce the length of hospital stay in normotensive patients with acute pulmonary embolism

  • Identification data

    Identifier: imarina:9262900
  • Authors:

    Jimenez, David
    Rodriguez, Carmen
    Leon, Francisco
    Jara-Palomares, Luis
    Lopez-Reyes, Raquel
    Ruiz-Artacho, Pedro
    Elias, Teresa
    Otero, Remedios
    Garcia-Ortega, Alberto
    Rivas-Guerrero, Agustina
    Abelaira, Jaime
    Jimenez, Sonia
    Muriel, Alfonso
    Morillo, Raquel
    Barrios, Deisy
    Le Mao, Raphael
    Yusen, Roger D.
    Bikdeli, Behnood
    Monreal, Manuel
    Luis Lobo, Jose
    IPEP Investigators
  • Others:

    Author, as appears in the article.: Jimenez, David; Rodriguez, Carmen; Leon, Francisco; Jara-Palomares, Luis; Lopez-Reyes, Raquel; Ruiz-Artacho, Pedro; Elias, Teresa; Otero, Remedios; Garcia-Ortega, Alberto; Rivas-Guerrero, Agustina; Abelaira, Jaime; Jimenez, Sonia; Muriel, Alfonso; Morillo, Raquel; Barrios, Deisy; Le Mao, Raphael; Yusen, Roger D.; Bikdeli, Behnood; Monreal, Manuel; Luis Lobo, Jose;IPEP Investigators
    Department: Medicina i Cirurgia
    URV's Author/s: Porras Ledantes, Jose Antonio
    Keywords: Burden Costs Early mobilization Mortality Outpatient
    Abstract: Background The length of hospital stay (LOS) for acute pulmonary embolism (PE) varies considerably. Whether the upfront use of a PE prognostic assessment and management pathway is effective in reducing the LOS remains unknown.Methods We conducted a randomised controlled trial of adults hospitalised for acute PE: patients were assigned either to a prognostic assessment and management pathway involving risk stratification followed by predefined criteria for mobilisation and discharge (intervention group) or to usual care (control group). The primary end-point was LOS. The secondary end-points were the cost of prognostic tests and of hospitalisation, and 30-day clinical outcomes.Results Of 500 patients who underwent randomisation, 498 were included in the modified intention-to-treat analysis. The median LOS was 4.0 days (interquartile range (IQR) 3.7-4.2 days) in the intervention group and 6.1 days (IQR 5.7-6.5 days) in the control group (p<0.001). The mean total cost of prognostic tests was EUR 174.76 in the intervention group, compared with EUR 233.12 in the control group (mean difference EUR -58.37, 95% CI EUR -84.34 to -32.40). The mean total hospitalisation cost per patient was EUR 2085.66 in the intervention group, compared with EUR 3232.97 in the control group (mean difference EUR -1147.31, 95% CI EUR -1414.97 to -879.65). No significant differences were observed in 30-day readmission (4.0% versus 4.8%), all-cause mortality (2.4% versus 2.0%) or PE-related mortality (0.8% versus 1.2%) rates.Conclusions The use of a prognostic assessment and management pathway was effective in reducing the LOS for acute PE.
    Thematic Areas: Biotecnología Ciências biológicas ii Ciências biológicas iii Educação física Engenharias iv General medicine Interdisciplinar Medicina i Medicina ii Medicina iii Medicine (miscellaneous) Nutrição Pulmonary and respiratory medicine Respiratory system Saúde coletiva
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    Author's mail: joseantonio.porras@urv.cat
    Author identifier: 0000-0001-6418-1822
    Record's date: 2023-02-23
    Papper version: info:eu-repo/semantics/acceptedVersion
    Link to the original source: https://erj.ersjournals.com/content/59/2/2100412
    Papper original source: European Respiratory Journal. 59 (2):
    APA: Jimenez, David; Rodriguez, Carmen; Leon, Francisco; Jara-Palomares, Luis; Lopez-Reyes, Raquel; Ruiz-Artacho, Pedro; Elias, Teresa; Otero, Remedios; Ga (2022). Randomised controlled trial of a prognostic assessment and management pathway to reduce the length of hospital stay in normotensive patients with acute pulmonary embolism. European Respiratory Journal, 59(2), -. DOI: 10.1183/13993003.00412-2021
    Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/
    Article's DOI: 10.1183/13993003.00412-2021
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2022
    Publication Type: Journal Publications
  • Keywords:

    Medicine (Miscellaneous),Pulmonary and Respiratory Medicine,Respiratory System
    Burden
    Costs
    Early mobilization
    Mortality
    Outpatient
    Biotecnología
    Ciências biológicas ii
    Ciências biológicas iii
    Educação física
    Engenharias iv
    General medicine
    Interdisciplinar
    Medicina i
    Medicina ii
    Medicina iii
    Medicine (miscellaneous)
    Nutrição
    Pulmonary and respiratory medicine
    Respiratory system
    Saúde coletiva
  • Documents:

  • Cerca a google

    Search to google scholar