Please select the eligibility criteria that correspond to the clinical trial below.
Title: Rapid Risk Stratification for Outpatient Treatment of Low-risk Pulmonary Embolism
Brief Summary: This study is looking at the safety and effectiveness of treating Patients diagnosed with a low-risk Pulmonary Embolism (PE) in an outpatient setting instead of the standard, in-patient hospitalization. Patients have several medical tests done during their Emergency Department visit. Based on those tests, those who are determined to have a low-risk PE are eligible to participate in the study. Those choosing to participate are discharged after 12 hours of medical observation. Patients who choose to participate are followed up by telephone approximately 90 days later.


Options:
A: Inclusion Criteria:

1. Pulmonary Embolism, diagnosed by CTA or high probability VQ Scan
2. Total Pulmonary Embolism Severity Index (PESI) score \<86

Exclusion Criteria:

1. Massive Pulmonary Embolism: Hypotension with signs of right heart strain on CTA or Echocardiogram
2. Sustained Systolic Blood Pressure (SBP) \<95 mmHg during Emergency Department or observation stay.
3. Age \<18
4. Pregnant
5. Renal insufficiency (Creatinine Clearance \<30)
6. Hepatic Dysfunction (AST/ALT/ALP \> 3 times upper limit of normal)
7. Unreliable social situation or inability to follow up
8. Contraindication to enoxaparin, warfarin and rivaroxaban
9. Atrial or ventricular dysrhythmia(s)
B: Inclusion Criteria:

* The consecutive outpatients subjects diagnosed of PE at 10 different Spanish hospitals.
* A score of 2 or under in our prediction rule (risk score for short-term)
* Signed written Informed consent

Exclusion Criteria:

* A score over 2 in our prediction rule
* Patients with a PE requiring thrombolysis or surgical thrombectomy
* Patients with right ventricular dyskinesia in echocardiography at 48 hours from heparin therapy. (It is not necessary echocardiography for the model of discharge at 5 days)
* Troponin level over 0,1 g/L
* Patiens requiring oxygen therapy or under 93% in oxygen saturation level.
* Patients requiring intravenous analgesic therapy
* Patients with some medical or surgical conditions requiring to stay at hospital
* Patients with advanced chronic cardiovascular diseases (dyspnea III-IV NYHA)
* Patients with advanced chronic respiratory diseases (several COPD criteria of GOLD with FEV1\< 50%)
* Documented congenital or acquired bleeding tendency /disorder (s)
* Documented current ulceration or angiodysplastic gastrointestinal disease
* Hemorrhagic stroke or recent (\< 3 months prior to randomization) brain, spinal, or ophthalmological surgery.
* Recent surgery \< 3 days
* Pregnancy
* Several Obesity (CMI over 30)
* Patients could not complete the treatment at home.
* Exclusion criteria related to study procedures
* Life expectancy \< 3 months
C: Inclusion Criteria:

* age \>18 years
* objectively confirmed diagnosis of pulmonary embolism
* patients at low-risk (Pulmonary Embolism Severity Index score \<=85)

Exclusion Criteria:

* patients at high-risk (Pulmonary Embolism Severity Index score \>85)
* presence of hypoxemia (arterial SO2 \<90% measured by pulse oximetry or an paO2 on room air of \<60 mm Hg measured by blood gas analysis)
* systolic blood pressure of \<100 mm Hg
* chest pain necessitating parenteral opioid administration
* active bleeding or at high-risk of major bleeding (stroke during the preceding 10 days, gastrointestinal bleeding during the preceding 14 days, or platelets \<75,000 per mm3)
* renal failure (creatinine clearance of \<30 ml/minute based on the Cockcroft-Gault formula)
* body mass \>150 kg
* history of HIT or allergy to heparins
* therapeutic oral anticoagulation (INR ≥2)at the time of pulmonary embolism diagnosis
* potential barriers to treatment adherence or follow-up (alcoholism, illicit current or recent drug use, psychosis, dementia, homelessness, lack of telephone access, transportation time to nearest ED \>45 minutes)
* known pregnancy
* imprisonment
* diagnosis of pulmonary embolism \>23 hours ago
* refusal or inability to provide informed consent
* prior enrollment in the study
D: Inclusion Criteria:

* outpatient with a pulmonary embolism, confirmed by locally approved guidelines
* aged 18 years and above
* written informed consent

Exclusion Criteria:

* hemodynamic or respiratory instability defined as one of the following; hypotension RR systolic\< 90 mmHg,pulse rate\> 100 bpm, need for oxygen therapy to maintain oxygen saturation above 90 %, collapse
* illness unrelated to PE for which the patient would require hospitalization
* pain requiring intravenous narcotics
* thrombolysis
* active bleeding or thrombopathy
* pregnancy
* in hospital patients
* physical or psychiatric inability for home treatment
* no support system at home renal insufficiency

Answer: A