Low-Risk Pulmonary Embolism Patients Can Be Discharged from the ED

Patients with pulmonary embolism (PE) — even those with low-risk PE — are usually admitted and treated with some form of parenteral heparin prior to discharge on an oral anticoagulant. Although recent guidelines from the American College of Emergency Physicians and American College of Chest Physicians recommend early discharge with initiation of oral anticoagulation for low risk PE patients, that is not yet usual practice (NEJM JW Emerg Med Feb 2016 and Chest 2016; 149:315). In an industry-funded, multicenter U.S. trial, researchers randomized 114 emergency department (ED) patients with low-risk PE (defined by the Hestia criteria) to early discharge on rivaroxaban or standard care. The primary outcomes were hospital length of stay and bleed…