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April 14, 2008

Length of Stay and Mortality in Pulmonary Embolism: High Time for Evidence-Based Discharge Criteria

Arch Intern Med. 2008;168(7):683-684. doi:10.1001/archinte.168.7.683

In 1960, Barritt and Jordan1 published a report of a randomized trial demonstrating the mortality benefit of anticoagulation in the treatment of acute pulmonary embolism (PE).The control arm of the study was terminated when 5 of 19 patients in that arm died of recurrent PE and 5 additional patients experienced recurrent nonfatal PE. Of 54 patients treated with anticoagulants, 1 experienced recurrent nonfatal PE, and 2 died from other causes—1 from bleeding. Patients in both arms stayed in the hospital at least 10 days during mandated bed rest. Only 1 of the 7 deaths occurred within the first week after diagnosis.