Long-Term Management of Pulmonary Embolism: A Review of Consequences, Treatment, and Rehabilitation

Anette Arbjerg Højen, Peter Brønnum Nielsen, Thure Filskov Overvad, Ida Ehlers Albertsen, Frederikus A. Klok, Nanna Rolving, Mette Søgaard, Anne Gulbech Ording*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

3 Citations (Scopus)
34 Downloads (Pure)

Abstract

The concept of pulmonary embolism is evolving. Recent and emerging evidence on the treatment of specific patient populations, its secondary prevention, long-term complications, and the unmet need for rehabilitation has the potential to change clinical practice for the benefit of the patients. This review discusses the recent evidence from clinical trials, observational studies, and guidelines focusing on anticoagulation treatment, rehabilitation, emotional stress, quality of life, and the associated outcomes for patients with pulmonary embolism. Guidelines suggest that the type and duration of treatment with anticoagulation should be based on prevalent risk factors. Recent studies demonstrate that an anticoagulant treatment that is longer than two years may be effective and safe for some patients. The evidence for extended treatment in cancer patients is limited. Careful consideration is particularly necessary for pulmonary embolisms in pregnancy, cancer, and at the end of life. The rehabilitation and prevention of unnecessary deconditioning, emotional distress, and a reduced quality of life is an important, but currently they are unmet priorities for many patients with a pulmonary embolism. Future research could demonstrate optimal anticoagulant therapy durations, follow-ups, and rehabilitation, and effective patient-centered decision making at the end of life. A patient preferences and shared decision making should be incorporated in their routine care when weighing the benefits and risks with primary treatment and secondary prevention.

Original languageEnglish
Article number5970
JournalJournal of Clinical Medicine
Volume11
Issue number19
ISSN2077-0383
DOIs
Publication statusPublished - 10 Oct 2022

Keywords

  • anticoagulation
  • bleeding
  • cancer-associated thrombosis
  • long-term management
  • patient preferences
  • pulmonary embolism
  • recurrence
  • rehabilitation
  • review

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