Prospective Study for the Outpatient Treatment of Patients With Very Low Risk Acute Symptomatic Pulmonary Embolism.

Last updated: May 9, 2023
Sponsor: Clinica Universidad de Navarra, Universidad de Navarra
Overall Status: Active - Recruiting

Phase

N/A

Condition

Pulmonary Embolism

Deep Vein Thrombosis

Chest Pain

Treatment

Outpatient treatment with standard anticoagulant therapy

Clinical Study ID

NCT05852119
295-22
  • Ages > 18
  • All Genders

Study Summary

Objectives: To evaluate the safety of outpatient treatment of patients with very low-risk pulmonary embolism (PE), and the satisfaction and quality of life of this management.

Methods: An experimental study of routine clinical practice will be carried out in which 300 consecutive hemodynamically stable patients with acute symptomatic PE will be included, who meet all the inclusion criteria and none of the exclusion criteria. All patients included in the study will be treated on an outpatient basis, that is, they will be discharged within the first 24 hours of the diagnosis of PE in the Emergency Department. The Computerized Registry of Thromboembolic Disease RIETE (Registro Informatizado de Enfermedad TromboEmbólica) will be used to collect the data in electronic case report form (CRF) and ensure the quality of the data.

Setting: Emergency, Pneumology and Internal Medicine Services of 10 Spanish hospitals.

Analysis: An intention-to-treat (ITT) analysis will be performed on all patients who sign the informed consent and are included in the study (regardless of whether or not they receive the assigned strategy). Additionally, an analysis of all patients who are treated on an outpatient basis without deviations or violations of the protocol will be performed. The primary outcome considered will be the composite of recurrent PE, major bleeding, or death from any cause during the first 30 days after enrollment in the study. Patient satisfaction and quality of life will be considered as secondary outcomes.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Confirmation of suspected pulmonary embolism (PE) by multidetector chest angiocomputed tomography (CT), if a contrast-encircled partial intraluminal defect orcomplete pulmonary artery occlusion is demonstrated on two consecutive CT slices (13);
  • Right ventricle (RV) diameter equal to or less than that of the left ventricle (LV) (RV/LV ratio ≤1) on chest CT angiography (see Study Procedures); and
  • Negatively modified simplified Pulmonary Embolism Severity Index (sPESI) scale at thetime of evaluation of the patient in the Emergency Department.

Exclusion

Exclusion Criteria:

  • Inability to obtain informed consent
  • Pregnancy
  • Hemodynamic instability at diagnosis (defined by systolic blood pressure (SBP) <90 mmHg, indication of fibrinolytic treatment or inferior vena cava filter, need forvasoactive drugs at the discretion of the attending physician, cardiopulmonaryresuscitation or orotracheal intubation)
  • Contraindication for anticoagulation, at the discretion of the responsible physician;
  • Estimated survival of less than 3 months
  • Need for thrombectomy, vena cava filter insertion, or need for fibrinolytic treatmentof the PE episode at the time of diagnosis
  • Participation in a clinical trial for the treatment of venous thromboembolic disease
  • Impossibility of follow up

Study Design

Total Participants: 300
Treatment Group(s): 1
Primary Treatment: Outpatient treatment with standard anticoagulant therapy
Phase:
Study Start date:
April 10, 2023
Estimated Completion Date:
February 28, 2026

Connect with a study center

  • Hospital Clinic

    Barcelona,
    Spain

    Site Not Available

  • Hospital General Universitari de Castelló

    Castelló,
    Spain

    Site Not Available

  • Hospital Universitario Donostia

    Donostia,
    Spain

    Site Not Available

  • Hospital Universitario Virgen de las Nieves

    Granada,
    Spain

    Site Not Available

  • Hospital San Pedro

    Logroño,
    Spain

    Site Not Available

  • Clínica Universidad Navarra

    Madrid, 28027
    Spain

    Site Not Available

  • Hospital Gregorio Marañón

    Madrid,
    Spain

    Site Not Available

  • Hospital Ramón y Cajal

    Madrid,
    Spain

    Active - Recruiting

  • Complejo Hospitalario Virgen del Rocío

    Sevilla,
    Spain

    Site Not Available

  • Hospital Doctor Peset

    Valencia,
    Spain

    Site Not Available

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