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Key Factors Guide Lung Clot Care
2006-1-25 9:04:49

Ten simple risk factors can help doctors identify the best treatment for patients with a clot in the lungs, a new study finds.

These risk markers can separate those patients with a pulmonary embolism who are at low risk of short-term death and are good candidates for outpatient treatment, concludes a Swiss study in the Jan. 23 issue of the Archives of Internal Medicine.

Pulmonary embolism occurs when a blood clot that forms in a leg or the pelvis breaks free and travels to the lungs, where it can cause a blockage in an artery. These types of clots can be fatal and cause more than 100,000 hospitalizations in the United States each year.

Researchers at the University of Lausanne analyzed data from more than 10,000 pulmonary embolism patients and identified 10 risk factors that indicated a greater risk of short-term death (within 30 days). These risk factors include: an age of 70 years or older; a history of cancer, heart failure, chronic lung disease or chronic kidney disease; cardiovascular disease; altered mental status; high pulse rate; low systolic blood pressure; and reduced oxygen saturation in arterial blood.

Patients without any of these risk factors are considered to be at low risk for short-term death and eligible for outpatient treatment, the study said.

The researchers noted that if 20 percent of people with pulmonary embolism received outpatient treatment instead of inpatient care, this would result in health-care savings of up to $91 million a year in the United States.

In an accompanying editorial, Dr. Lisa K. Moores, of Walter Reed Army Medical Center in Washington, D.C., called the study exciting because it is the first to combine several factors into a score that can be used to determine the appropriate treatment setting.

Perhaps more importantly, the risk score can be calculated quickly and reliably with clinical data easily obtained in the initial history review and physical examination, Moores noted.

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