Comprehensive clinic-based care may be acceptable for carefully selected adults diagnosed with acute pulmonary embolism in the primary care setting, according to a study published in the Journal of General Internal Medicine. David R. Vinson, MD, and colleagues described 30-day outcomes stratified by initial site-of-care decisions in a multicenter retrospective cohort study. Data were included for 652 patient encounters from 646 patients, among which 20.6% were sent home from primary care and 79.4% were initially referred to the ED or hospital. Overall, 37.8% of those who were initially referred were discharged home without events. A 30-day serious adverse event was experienced by eight patients (1.2%) and included venous thromboembolism, major bleed, and death (4, 1, and 3 patients, respectively). Of these patients, seven were initially hospitalized and one had been sent home from primary care. About half (50.3%) of the patients were hospitalized within 7 days.
