Summary of best evidence for follow-up management of non-pregnant adult with pulmonary embolism_West China Medical Journal

Authors：

HUANG Xun ¹ , HAN Yueyue ² , ZHAO Xinyi ¹ , ZHANG Haorui ¹ ,  DONG Li ¹

1. First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300193, P. R. China;
2. Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P. R. China;

Corresponding?author：

DONG Li, Email: 15022008086@139.com

Keywords：

Pulmonary embolism; follow-up; continuity nursing; evidence summary; evidence-based nursing

DOI：

10.7507/1002-0179.202401043

Video：

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Objective To evaluate and summarize the relevant evidence on follow-up management of non-pregnant adult with pulmonary embolism, and provide a reference for optimizing the follow-up plan of non-pregnant adult with pulmonary embolism. Methods Clinical decision-making, guidelines, societies/associations websites related to follow-up of pulmonary embolism, and databases were searched for literature on follow-up management of non-pregnant adult with pulmonary embolism. The retrieval time limit was from databases establishment to December 2023. The included literature was evaluated for quality and summarized to form evidence. Results A total of 13 articles were included, including 3 clinical decision-making articles, 5 guidelines, 1 systematic review, and 4 expert consensus articles, forming 26 best pieces of evidence, involving 8 aspects of follow-up personnel and methods, follow-up time, physical assessment, activity guidance, contraception guidance, filter management, medication guidance, and lifestyle guidance. Conclusions The follow-up management of non-pregnant adult with pulmonary embolism is very important. When medical staff apply relevant follow-up management evidence, they should fully evaluate the patients’ willingness and medical environment, make full use of existing resources, optimize follow-up management strategies, reduce the occurrence of complications, and improve patient prognosis.

Citation： HUANG Xun, HAN Yueyue, ZHAO Xinyi, ZHANG Haorui, DONG Li. Summary of best evidence for follow-up management of non-pregnant adult with pulmonary embolism. West China Medical Journal, 2024, 39(11): 1759-1765. doi: 10.7507/1002-0179.202401043 Copy

1.	中華醫學會心血管病學分會肺血管病學組. 急性肺栓塞診斷與治療中國專家共識(2015). 中華心血管病雜志, 2016, 44(3): 197-211.
2.	Hoover J. Pulmonary embolism. N Engl J Med, 2022, 387(13): 1242-1243.
3.	Duffett L, Castellucci LA, Forgie MA. Pulmonary embolism: update on management and controversies. BMJ, 2020, 370: m2177.
4.	Durrington C, Hurdman JA, Elliot CA, et al. Systematic pulmonary embolism follow-up increases diagnostic rates of chronic thromboembolic pulmonary hypertension and identifies less severe disease: results from the ASPIRE registry. Eur Respir J, 2024, 63(3): 2300846.
5.	Hoejen AA, Larsen TB, Hansen AS, et al. Experiences, perspectives, and practice patterns of pulmonary embolism follow-up in Denmark. A mixed method study informing the development of a structured integrated post PE care model. Eur Heart J, 2022: 43.
6.	潘姝丞, 張淑香, 喬文博, 等. 低危肺栓塞門診治療的研究進展. 現代臨床護理, 2022, 21(8): 74-80.
7.	Brouwers MC, Kho ME, Browman GP, et al. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ, 2010, 182(18): E839-E842.
8.	Foster MJ, Shurtz S. Making the critical appraisal for summaries of evidence (CASE) for evidence-based medicine (EBM): critical appraisal of summaries of evidence. J Med Libr Assoc, 2013, 101(3): 192-198.
9.	朱政, 胡雁, 周英鳳, 等. 推動證據向臨床轉化(五)證據臨床轉化研究中的文獻質量評價. 護士進修雜志, 2020, 35(11): 996-1000.
10.	Lu Y, Yuan Z, Han Y, et al. Summary of best evidence for enhanced recovery after surgery for patients undergoing lung cancer operations. Asia Pac J Oncol Nurs, 2022, 9(7): 100054.
11.	王春青, 胡雁. JBI 證據預分級及證據推薦級別系統(2014 版). 護士進修雜志, 2015(11): 964-967.
12.	Weinberg AS, Rali P. Treatment, prognosis, and follow-up of acute pulmonary embolism in adults. Waltham: UpToDate, 2023.
13.	Lip GY, Hull RD, Garcia DA. Selecting adult patients with lower extremity deep venous thrombosis and pulmonary embolism for indefinite anticoagulation. Waltham: UpToDate, 2023.
14.	Thompson BT. Patient education: pulmonary embolism. Waltham: UpToDate, 2023.
15.	Ortel TL, Neumann I, Ageno W, et al. American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism. Blood Adv, 2020, 4(19): 4693-4738.
16.	Harrison S. Venous thromboembolic diseases: diagnosis, management and thrombophilia testing. London: National Institute for Health and Care Excellence, 2020.
17.	Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J, 2020, 41(4): 543-603.
18.	Howard LSGE, Barden S, Condliffe R, et al. British Thoracic Society guideline for the initial outpatient management of pulmonary embolism (PE). Thorax, 2018, 73(Suppl 2): ii1-ii29.
19.	中華醫學會呼吸病學分會肺栓塞與肺血管病學組, 中國醫師協會呼吸醫師分會肺栓塞與肺血管病工作委員會, 全國肺栓塞與肺血管病防治協作組. 肺血栓栓塞癥診治與預防指南. 中華醫學雜志, 2018, 98(14): 1060-1087.
20.	Yoo HH, Nunes-Nogueira VS, Fortes Villas Boas PJ, et al. Outpatient versus inpatient treatment for acute pulmonary embolism. Cochrane Database Syst Rev, 2022, 5(5): CD010019.
21.	Klok FA, Ageno W, Ay C, et al. Optimal follow-up after acute pulmonary embolism: a position paper of the European Society of Cardiology Working Group on pulmonary circulation and right ventricular function, in collaboration with the European Society of Cardiology Working Group on atherosclerosis and vascular biology, endorsed by the European Respiratory Society. Eur Heart J, 2022, 43(3): 183-189.
22.	Expert Panel on Cardiac Imaging, Kirsch J, Wu CC, et al. ACR appropriateness criteria^? suspected pulmonary embolism: 2022 update. J Am Coll Radiol, 2022, 19(11S): S488-S501.
23.	Rivera-Lebron B, McDaniel M, Ahrar K, et al. Diagnosis, treatment and follow up of acute pulmonary embolism: consensus practice from the PERT consortium. Clin Appl Thromb Hemost, 2019, 25: 1076029619853037.
24.	D’Agostino C, Zonzin P, Enea I, et al. ANMCO position paper: long-term follow-up of patients with pulmonary thromboembolism. Eur Heart J, 2017, 19(Suppl D): D309-D332.
25.	Barnes G, Giri J, Courtney DM, et al. Nuts and bolts of running a pulmonary embolism response team: results from an organizational survey of the national PERT^TM consortium members. Hosp Pract (1995), 2017, 45(3): 76-80.
26.	中華醫學會心血管病學分會, 中國醫師協會心血管內科醫師分會肺血管疾病學組, 中國肺栓塞救治團隊(PERT)聯盟. 急性肺栓塞多學科團隊救治中國專家共識. 中華心血管病雜志, 2022, 50(1): 25-35.
27.	Sheikh MA, VanAken G, Hyder SN, et al. Outpatient follow-up of pulmonary embolism: putting it all together. Interv Cardiol Clin, 2023, 12(3): 429-441.
28.	Boon GJAM, Bogaard HJ, Klok FA. Essential aspects of the follow-up after acute pulmonary embolism: an illustrated review. Res Pract Thromb Haemost, 2020, 4(6): 958-968.
29.	Becattini C, Franco L, Agnelli G. Acute pulmonary embolism after discharge: duration of therapy and follow-up testing. Semin Respir Crit Care Med, 2017, 38(1): 94-106.
30.	Barco S, Valerio L, Jankowski M, et al. Functional outcomes and quality of life during long-term follow-up after acute pulmonary embolism: analysis of the prospective multicentre FOCUS study. Eur Heart J, 2020, 41(Suppl 2): ehaa946-ehaa2277.
31.	Andò G, Pelliccia F, Saia F, et al. Management of high and intermediate-high risk pulmonary embolism: a position paper of the Interventional Cardiology Working Group of the Italian Society of Cardiology. Int J Cardiol, 2024, 400: 131694.
32.	Piepoli MF, Hoes AW, Agewall S, et al. 2016 European guidelines on cardiovascular disease prevention in clinical practice: the sixth joint task force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of 10 societies and by invited experts) developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J, 2016, 37(29): 2315-2381.
33.	Klok FA, Huisman MV. How I assess and manage the risk of bleeding in patients treated for venous thromboembolism. Blood, 2020, 135(10): 724-734.
34.	Delcroix M, Torbicki A, Gopalan D, et al. ERS statement on chronic thromboembolic pulmonary hypertension. Eur Respir J, 2021, 57(6): 2002828.
35.	Howard LS, Price LC. Systematic pulmonary embolism follow-up: why we should all do it!. Eur Respir J, 2024, 63(3): 2400253.
36.	Steinke EE, Jaarsma T, Barnason SA, et al. Sexual counselling for individuals with cardiovascular disease and their partners: a consensus document from the American Heart Association and the ESC Council on Cardiovascular Nursing and Allied Professions (CCNAP). Eur Heart J, 2013, 34(41): 3217-3235.

1. 中華醫學會心血管病學分會肺血管病學組. 急性肺栓塞診斷與治療中國專家共識(2015). 中華心血管病雜志, 2016, 44(3): 197-211.
2. Hoover J. Pulmonary embolism. N Engl J Med, 2022, 387(13): 1242-1243.
3. Duffett L, Castellucci LA, Forgie MA. Pulmonary embolism: update on management and controversies. BMJ, 2020, 370: m2177.
4. Durrington C, Hurdman JA, Elliot CA, et al. Systematic pulmonary embolism follow-up increases diagnostic rates of chronic thromboembolic pulmonary hypertension and identifies less severe disease: results from the ASPIRE registry. Eur Respir J, 2024, 63(3): 2300846.
5. Hoejen AA, Larsen TB, Hansen AS, et al. Experiences, perspectives, and practice patterns of pulmonary embolism follow-up in Denmark. A mixed method study informing the development of a structured integrated post PE care model. Eur Heart J, 2022: 43.
6. 潘姝丞, 張淑香, 喬文博, 等. 低危肺栓塞門診治療的研究進展. 現代臨床護理, 2022, 21(8): 74-80.
7. Brouwers MC, Kho ME, Browman GP, et al. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ, 2010, 182(18): E839-E842.
8. Foster MJ, Shurtz S. Making the critical appraisal for summaries of evidence (CASE) for evidence-based medicine (EBM): critical appraisal of summaries of evidence. J Med Libr Assoc, 2013, 101(3): 192-198.
9. 朱政, 胡雁, 周英鳳, 等. 推動證據向臨床轉化(五)證據臨床轉化研究中的文獻質量評價. 護士進修雜志, 2020, 35(11): 996-1000.
10. Lu Y, Yuan Z, Han Y, et al. Summary of best evidence for enhanced recovery after surgery for patients undergoing lung cancer operations. Asia Pac J Oncol Nurs, 2022, 9(7): 100054.
11. 王春青, 胡雁. JBI 證據預分級及證據推薦級別系統(2014 版). 護士進修雜志, 2015(11): 964-967.
12. Weinberg AS, Rali P. Treatment, prognosis, and follow-up of acute pulmonary embolism in adults. Waltham: UpToDate, 2023.
13. Lip GY, Hull RD, Garcia DA. Selecting adult patients with lower extremity deep venous thrombosis and pulmonary embolism for indefinite anticoagulation. Waltham: UpToDate, 2023.
14. Thompson BT. Patient education: pulmonary embolism. Waltham: UpToDate, 2023.
15. Ortel TL, Neumann I, Ageno W, et al. American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism. Blood Adv, 2020, 4(19): 4693-4738.
16. Harrison S. Venous thromboembolic diseases: diagnosis, management and thrombophilia testing. London: National Institute for Health and Care Excellence, 2020.
17. Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J, 2020, 41(4): 543-603.
18. Howard LSGE, Barden S, Condliffe R, et al. British Thoracic Society guideline for the initial outpatient management of pulmonary embolism (PE). Thorax, 2018, 73(Suppl 2): ii1-ii29.
19. 中華醫學會呼吸病學分會肺栓塞與肺血管病學組, 中國醫師協會呼吸醫師分會肺栓塞與肺血管病工作委員會, 全國肺栓塞與肺血管病防治協作組. 肺血栓栓塞癥診治與預防指南. 中華醫學雜志, 2018, 98(14): 1060-1087.
20. Yoo HH, Nunes-Nogueira VS, Fortes Villas Boas PJ, et al. Outpatient versus inpatient treatment for acute pulmonary embolism. Cochrane Database Syst Rev, 2022, 5(5): CD010019.
21. Klok FA, Ageno W, Ay C, et al. Optimal follow-up after acute pulmonary embolism: a position paper of the European Society of Cardiology Working Group on pulmonary circulation and right ventricular function, in collaboration with the European Society of Cardiology Working Group on atherosclerosis and vascular biology, endorsed by the European Respiratory Society. Eur Heart J, 2022, 43(3): 183-189.
22. Expert Panel on Cardiac Imaging, Kirsch J, Wu CC, et al. ACR appropriateness criteria^? suspected pulmonary embolism: 2022 update. J Am Coll Radiol, 2022, 19(11S): S488-S501.
23. Rivera-Lebron B, McDaniel M, Ahrar K, et al. Diagnosis, treatment and follow up of acute pulmonary embolism: consensus practice from the PERT consortium. Clin Appl Thromb Hemost, 2019, 25: 1076029619853037.
24. D’Agostino C, Zonzin P, Enea I, et al. ANMCO position paper: long-term follow-up of patients with pulmonary thromboembolism. Eur Heart J, 2017, 19(Suppl D): D309-D332.
25. Barnes G, Giri J, Courtney DM, et al. Nuts and bolts of running a pulmonary embolism response team: results from an organizational survey of the national PERT^TM consortium members. Hosp Pract (1995), 2017, 45(3): 76-80.
26. 中華醫學會心血管病學分會, 中國醫師協會心血管內科醫師分會肺血管疾病學組, 中國肺栓塞救治團隊(PERT)聯盟. 急性肺栓塞多學科團隊救治中國專家共識. 中華心血管病雜志, 2022, 50(1): 25-35.
27. Sheikh MA, VanAken G, Hyder SN, et al. Outpatient follow-up of pulmonary embolism: putting it all together. Interv Cardiol Clin, 2023, 12(3): 429-441.
28. Boon GJAM, Bogaard HJ, Klok FA. Essential aspects of the follow-up after acute pulmonary embolism: an illustrated review. Res Pract Thromb Haemost, 2020, 4(6): 958-968.
29. Becattini C, Franco L, Agnelli G. Acute pulmonary embolism after discharge: duration of therapy and follow-up testing. Semin Respir Crit Care Med, 2017, 38(1): 94-106.
30. Barco S, Valerio L, Jankowski M, et al. Functional outcomes and quality of life during long-term follow-up after acute pulmonary embolism: analysis of the prospective multicentre FOCUS study. Eur Heart J, 2020, 41(Suppl 2): ehaa946-ehaa2277.
31. Andò G, Pelliccia F, Saia F, et al. Management of high and intermediate-high risk pulmonary embolism: a position paper of the Interventional Cardiology Working Group of the Italian Society of Cardiology. Int J Cardiol, 2024, 400: 131694.
32. Piepoli MF, Hoes AW, Agewall S, et al. 2016 European guidelines on cardiovascular disease prevention in clinical practice: the sixth joint task force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of 10 societies and by invited experts) developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J, 2016, 37(29): 2315-2381.
33. Klok FA, Huisman MV. How I assess and manage the risk of bleeding in patients treated for venous thromboembolism. Blood, 2020, 135(10): 724-734.
34. Delcroix M, Torbicki A, Gopalan D, et al. ERS statement on chronic thromboembolic pulmonary hypertension. Eur Respir J, 2021, 57(6): 2002828.
35. Howard LS, Price LC. Systematic pulmonary embolism follow-up: why we should all do it!. Eur Respir J, 2024, 63(3): 2400253.
36. Steinke EE, Jaarsma T, Barnason SA, et al. Sexual counselling for individuals with cardiovascular disease and their partners: a consensus document from the American Heart Association and the ESC Council on Cardiovascular Nursing and Allied Professions (CCNAP). Eur Heart J, 2013, 34(41): 3217-3235.

West China Medical Journal

Summary of best evidence for follow-up management of non-pregnant adult with pulmonary embolism

Abstract Full text Figures/Tables Video References Cited by

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