Table 6

Clinical exclusion criteria for outpatient pulmonary embolism (PE) management

Hestia criteria (Zondag et al)8 Davies et al 9
Is the patient haemodynamically unstable?*Yes/noNeed for hospitalisation for another medical reasonYes/no
Is thrombolysis or embolectomy necessary?Yes/noAdditional monitoring required (ECG, oxygen, parenteral analgesia)Yes/no
Active bleeding or high risk of bleeding?†Yes/noLikelihood of poor compliance/difficulty with follow-upYes/no
More than 24 hours of oxygen supply to maintain oxygen saturation>90%?Yes/noPrevious PE/early recurrence of PEYes/no
Is PE diagnosed during anticoagulant treatment?Yes/noCoexisting major DVTYes/no
Severe pain needing intravenous pain medication for>24 hours?Yes/noBleeding disorders, active bleedingYes/no
Medical or social reason for treatment in hospital>24 hours?Yes/noPregnancyYes/no
Does the patient have a creatinine clearance<30 mL/min?Yes/noPatient preference for hospital stayYes/no
Does the patient have severe liver impairment? (discretion of clinician)Yes/no
Is the patient pregnant?Yes/no
Does the patient have a documented history of heparin-induced thrombocytopenia?Yes/no
Eligible for outpatient treatment: no risk factors
Ineligible for outpatient treatment: at least one risk factor present
  • *SBP <100 mm Hg with HR >100 bpm; condition requiring admission to intensive care unit.

  • †Gastrointestinal bleeding in the preceding 14 days, recent stroke (<4 weeks ago), recent operation (<2 weeks ago), bleeding disorder, thrombocytopenia (platelet count <75×109/L), uncontrolled hypertension (SBP >180 mm Hg or DBP >110 mm Hg).

  • DVT, deep vein thrombosis; SBP, systolic blood pressure.