Trial reportEuropean heart journal2021
Triaging acute pulmonary embolism for home treatment by Hestia or simplified PESI criteria: the HOME-PE randomized trial.
Trial report in European heart journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 60 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Criteria for Hospitalization or Outpatient Management of Patients With Pulmonary Embolism, Hestia Rule Versus Simplified PESI Score : an Open-label Controlled Randomized International Trial (HOME-PE)
HOME-PE2 : Home Treatment Versus Hospitalization in Patients With Acute Pulmonary Embolism, no Clinical Severity Criteria, and Either Right Ventricular Dysfunction or Elevated Troponin: a Randomized Controlled Trial
Who cites it
60 citing papers in PubMed, 4 syntheses or guidelines pooled it, 140 citations in OpenAlex.
- Criteria for home treatment of patients with acute pulmonary embolism (the Emergency Advisory and Research international board on Thrombosis and Hemostasis EARTH - rule): an international Delphi consensus study.Journal of thrombosis and haemostasis : JTH · 2025Pooled it
- Safety of treating acute pulmonary embolism at home: an individual patient data meta-analysis.European heart journal · 2024Pooled it
- Outpatient versus inpatient treatment for acute pulmonary embolism.The Cochrane database of systematic reviews · 2022Pooled it
- Prognostic Performance of Hestia Criteria in Acute Pulmonary Embolism: A Systematic Review and Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- Association between albumin-bilirubin (ALBI) score and all-cause mortality in critically ill patients with pulmonary embolism: a cohort study based on the MIMIC-IV database.Journal of thoracic disease · 2026Article
- Impact of Associated Infections on the Clinical Course and Risk-Stratification Profile of Pulmonary Embolism: Comparative Analysis Using PESI, Wells, Padua, and IMPROVE Scores.Diagnostics (Basel, Switzerland) · 2026Article
- Expanding outpatient eligibility using a narrow definition of cancer in the Pulmonary Embolism Severity Index.Research and practice in thrombosis and haemostasis · 2026Article
- Risk stratification in pulmonary embolism: current evidence and future directions.The Journal of cardiovascular surgery · 2026Review
- Adherence and barriers to early discharge for patients with low-risk pulmonary embolism at a Latin American tertiary center: A retrospective cohort study.The Journal of international medical research · 2026Article
- Safety and efficacy of low-dose versus high-dose alteplase for pulmonary embolism: a retrospective study from MIMIC-IV.Journal of thoracic disease · 2026Article
- Contemporary Challenges in Venous Thromboembolism: Evolving Populations and Implications for Management and Risk Stratification.Journal of clinical medicine · 2026Review
- Pulmonary embolism consensus.Archivos de cardiologia de Mexico · 2026Article
- Comparative analysis of clinical decision tools for acute pulmonary embolism at a tertiary care center.Bioinformation · 2026Article
- Outpatient Management of Pulmonary Embolism Patients with Direct Oral Anticoagulants: A Systematic Review.Journal of clinical medicine · 2025Review
- Clinical safety of home treatment for pulmonary embolism: a multicenter registry study of the Asian population.Research and practice in thrombosis and haemostasis · 2025Article
- [Diagnosis and treatment of acute pulmonary embolism].Radiologie (Heidelberg, Germany) · 2025Review
- Preventing, identifying, and managing sepsis in the community: research and clinical priorities.The Lancet. Primary care · 2025Article
- Care pathway for patients hospitalized with venous thromboembolism.European journal of clinical investigation · 2025Article
- [Diagnosis and treatment of acute pulmonary embolism].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Review
- Association of pan-immune inflammation value with mortality in patients with pulmonary embolism: a cohort study.Scientific reports · 2025Article
Corrections and comments
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Authors and funding
41 authors at 20 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsThe aim of this study is to compare the Hestia rule vs. the simplified Pulmonary Embolism Severity Index (sPESI) for triaging patients with acute pulmonary embolism (PE) for home treatment. METHODS AND
resultsNormotensive patients with PE of 26 hospitals from France, Belgium, the Netherlands, and Switzerland were randomized to either triaging with Hestia or sPESI. They were designated for home treatment if the triaging tool was negative and if the physician-in-charge, taking into account the patient's opinion, did not consider that hospitalization was required. The main outcomes were the 30-day composite of recurrent venous thrombo-embolism, major bleeding or all-cause death (non-inferiority analysis with 2.5% absolute risk difference as margin), and the rate of patients discharged home within 24 h after randomization (NCT02811237). From January 2017 through July 2019, 1975 patients were included. In the per-protocol population, the primary outcome occurred in 3.82% (34/891) in the Hestia arm and 3.57% (32/896) in the sPESI arm (P = 0.004 for non-inferiority). In the intention-to-treat population, 38.4% of the Hestia patients (378/984) were treated at home vs. 36.6% (361/986) of the sPESI patients (P = 0.41 for superiority), with a 30-day composite outcome rate of 1.33% (5/375) and 1.11% (4/359), respectively. No recurrent or fatal PE occurred in either home treatment arm.
conclusionsFor triaging PE patients, the strategy based on the Hestia rule and the strategy based on sPESI had similar safety and effectiveness. With either tool complemented by the overruling of the physician-in-charge, more than a third of patients were treated at home with a low incidence of complications.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.