The quality of evidence is downgraded by imprecise results (wide confidence intervals and few patients and outcome events) and by by suspected publication bias.
A Cochrane review [Abstract] 1 included 2 studies with a total of 453 adult subjects diagnosed with low-risk acute pulmonary embolism (PE). Both studies discharged patients randomised to the outpatient group within 36 hours of initial triage and both followed participants for 90 days. One study compared the same treatment regimens in both outpatient and inpatient groups, and the other study used different treatment regimes.
There were no clear differences between outpatient and inpatient groups in short-term (30 days) mortality (RR 0.33, 95% CI 0.01 to 7.98), long-term (90 days) mortality (RR 0.98, 95% CI 0.06 to 15.58), major bleeding at 14 days (RR 4.91, 95% CI 0.24 to 101.57) and at 90 days (RR 6.88, 95% CI 0.36 to 132.14), minor bleeding (RR 1.08, 95% CI 0.07 to 16.79), recurrent PE within 90 days (RR 2.95, 95% CI 0.12 to 71.85), and participant satisfaction (RR 0.97, 95% CI 0.90 to 1.04). PE-related mortality, and adverse effects such as haemodynamic instability and compliance, were not assessed by the studies.
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