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. Key Messages A significant number of patients with venous thromboembolism (VTE) are still hospitalized for the acute phase of the treatment despite current guidelines recommending 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.