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/association 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.

1.	中华医学会心血管病学分会肺血管病学组. 急性肺栓塞诊断与治疗中国专家共识(2015). 中华心血管病杂志, 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, 张淑香, 乔文博, 等. 低危肺栓塞门诊治疗的研究进展. 现代临床护理, 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, 周英凤, 等. 推动证据向临床转化(五)证据临床转化研究中的文献质量评价. 护士进修杂志, 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 证据预分级及证据推荐级别系统(2014 版). 护士进修杂志, 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.	中华医学会呼吸病学分会肺栓塞与肺血管病学组, 中国医师协会呼吸医师分会肺栓塞与肺血管病工作委员会, 全国肺栓塞与肺血管病防治协作组. 肺血栓栓塞症诊治与预防指南. 中华医学杂志, 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^™ consortium members. Hosp Pract (1995), 2017, 45(3): 76-80.
26.	中华医学会心血管病学分会, 中国医师协会心血管内科医师分会肺血管疾病学组, 中国肺栓塞救治团队(PERT)联盟. 急性肺栓塞多学科团队救治中国专家共识. 中华心血管病杂志, 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. 中华医学会心血管病学分会肺血管病学组. 急性肺栓塞诊断与治疗中国专家共识(2015). 中华心血管病杂志, 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, 张淑香, 乔文博, 等. 低危肺栓塞门诊治疗的研究进展. 现代临床护理, 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, 周英凤, 等. 推动证据向临床转化(五)证据临床转化研究中的文献质量评价. 护士进修杂志, 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 证据预分级及证据推荐级别系统(2014 版). 护士进修杂志, 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. 中华医学会呼吸病学分会肺栓塞与肺血管病学组, 中国医师协会呼吸医师分会肺栓塞与肺血管病工作委员会, 全国肺栓塞与肺血管病防治协作组. 肺血栓栓塞症诊治与预防指南. 中华医学杂志, 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^™ consortium members. Hosp Pract (1995), 2017, 45(3): 76-80.
26. 中华医学会心血管病学分会, 中国医师协会心血管内科医师分会肺血管疾病学组, 中国肺栓塞救治团队(PERT)联盟. 急性肺栓塞多学科团队救治中国专家共识. 中华心血管病杂志, 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

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

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