Outpatient management of cancer-associated pulmonary embolism: a systematic review and meta-analysis.

This systematic reviewand meta-analysisaimed to evaluate the safety and feasibility of outpatient management of cancer-associated PE.

本系统评价和荟萃分析旨在评估癌症相关PE门诊管理的安全性和可行性。

Methods

We searched MEDLINE, Embase, Cochrane Central and Scopus databases from inception to 30 May 2024 for studies on outpatient management of cancer-associated PE.

我们检索了从建库至2024年5月30日的MEDLINE、Embase、Cochrane Central和Scopus数据库，以寻找关于门诊管理癌症相关肺栓塞的研究。

Eligible studies included randomised controlled trials, cohort studies and case-control studies with at least 10 patients.

符合条件的研究包括至少有10名患者的随机对照试验、队列研究和病例对照研究。

The primary outcome was 30-day all-cause mortality; secondary outcomes included VTE-related mortality, major bleeding and recurrent VTE at 30 days.

主要结果是30天内的全因死亡率；次要结果包括30天内的静脉血栓栓塞（VTE）相关死亡、重大出血和复发性VTE。

Meta-analysiswas performed using random effects models and heterogeneity was assessed with the I2-statistic.

使用随机效应模型进行了荟萃分析，并使用I2统计量评估了异质性。

Results

19 studies (13 full articles, six abstracts only) with a total of 1675 patients managed as outpatients were identified.

共识别出19项研究（13篇完整文章，六篇仅摘要），涉及总计1675名门诊管理的患者。

Criteria for outpatient management of cancer-associated PE were reported in 14 studies.

14项研究报告了癌症相关肺栓塞门诊管理的标准。

The pooled 30-day all-cause mortality rate was 1.74% (95% CI 0.99-3.03%; I2=0%; 691 patients, six full articles).

综合30天全因死亡率为1.74%（95%置信区间0.99-3.03%；I2=0%；691名患者，六篇完整文章）。

The 30-day major bleeding pooled rate was 2.71% (95% CI 1.51-4.83%; I2=0%; 406 patients, six full articles) and the 30-day recurrent VTE pooled rate was 1.26% (95% CI 0.53-3.00%; I2=0%; 396 patients, five full articles).

综合30天主要出血率为2.71%（95%置信区间1.51-4.83%；I2=0%；406名患者，六篇完整文章），以及30天复发性静脉血栓栓塞症（VTE）率为1.26%（95%置信区间0.53-3.00%；I2=0%；396名患者，五篇完整文章）。

Conclusions

Selected patients with cancer-associated PE managed as outpatients appear to have low short-term rates of mortality, major bleeding and recurrent VTE, suggesting this may be a safe strategy.

选择性管理的门诊癌症相关肺栓塞患者短期死亡率、主要出血和复发性VTE的发生率较低，这表明这种策略可能是安全的。

Further research with larger, prospective studies is needed to confirm these findings and refine risk stratification protocols.

需要更大规模的前瞻性研究来进一步验证这些发现，并完善风险分层协议。