TY - JOUR
T1 - Contemporary National Trends and Outcomes of Pulmonary Embolism in the United States
AU - Sedhom, Ramy
AU - Megaly, Michael
AU - Elbadawi, Ayman
AU - Elgendy, Islam Y.
AU - Witzke, Christian F.
AU - Kalra, Sanjog
AU - George, Jon C.
AU - Omer, Mohamed
AU - Banerjee, Subhash
AU - Jaber, Wissam A.
AU - Shishehbor, Mehdi H.
N1 - Funding Information:
Dr. Sanjog Kalra is a consultant and Speakers’ bureau and/or Advisory Board participant for Boston Scientific, Cardiovascular Systems Inc, Translumina Therapeutics, Abiomed Inc., and Philips Healthcare. Dr. Wissam Jaber receives consultation fees and research grants from Inari Medical. All other authors have no conflicts of interest to declare.
Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/8/1
Y1 - 2022/8/1
N2 - Contemporary data on the national trends in pulmonary embolism (PE) admissions and outcomes are scarce. We aimed to analyze trends in mortality and different treatment methods in acute PE. We queried the Nationwide Readmissions Database (2016 to 2019) to identify hospitalizations with acute PE using the International Classification of Diseases, Tenth Revision, Clinical Modification codes. We described the national trends in admissions, in-hospital mortality, readmissions, and different treatment methods in acute PE. We identified 1,427,491 hospitalizations with acute PE, 2.4% of them (n = 34,446) were admissions with high-risk PE. The rate of in-hospital mortality in all PE hospitalizations was 6.5%, and it remained unchanged throughout the study period. However, the rate of in-hospital mortality in high-risk PE decreased from 48.1% in the first quarter of 2016 to 38.9% in the last quarter of 2019 (p-trend <0.001). The rate of urgent 30-day readmission was 15.2% in all PE admissions and 19.1% in high-risk PE admissions. In all PE admissions, catheter-directed interventions (CDI) were used more often (2.5%) than systemic thrombolysis (ST) (2.1%). However, in admissions with high-risk PE, ST remained the most frequently used method (ST vs CDI: 11.3% vs 6.6%). In conclusion, this study showed that the rate of in-hospital mortality in high-risk PE decreased from 2016 to 2019. ST was the most frequently used method for achieving pulmonary reperfusion in high-risk PE, whereas CDI was the most frequently used method in the entire PE cohort. In-hospital death and urgent readmissions rates remain significantly high in patients with high-risk PE.
AB - Contemporary data on the national trends in pulmonary embolism (PE) admissions and outcomes are scarce. We aimed to analyze trends in mortality and different treatment methods in acute PE. We queried the Nationwide Readmissions Database (2016 to 2019) to identify hospitalizations with acute PE using the International Classification of Diseases, Tenth Revision, Clinical Modification codes. We described the national trends in admissions, in-hospital mortality, readmissions, and different treatment methods in acute PE. We identified 1,427,491 hospitalizations with acute PE, 2.4% of them (n = 34,446) were admissions with high-risk PE. The rate of in-hospital mortality in all PE hospitalizations was 6.5%, and it remained unchanged throughout the study period. However, the rate of in-hospital mortality in high-risk PE decreased from 48.1% in the first quarter of 2016 to 38.9% in the last quarter of 2019 (p-trend <0.001). The rate of urgent 30-day readmission was 15.2% in all PE admissions and 19.1% in high-risk PE admissions. In all PE admissions, catheter-directed interventions (CDI) were used more often (2.5%) than systemic thrombolysis (ST) (2.1%). However, in admissions with high-risk PE, ST remained the most frequently used method (ST vs CDI: 11.3% vs 6.6%). In conclusion, this study showed that the rate of in-hospital mortality in high-risk PE decreased from 2016 to 2019. ST was the most frequently used method for achieving pulmonary reperfusion in high-risk PE, whereas CDI was the most frequently used method in the entire PE cohort. In-hospital death and urgent readmissions rates remain significantly high in patients with high-risk PE.
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U2 - 10.1016/j.amjcard.2022.03.060
DO - 10.1016/j.amjcard.2022.03.060
M3 - Article
C2 - 35637010
AN - SCOPUS:85131142423
SN - 0002-9149
VL - 176
SP - 132
EP - 138
JO - American Journal of Cardiology
JF - American Journal of Cardiology
ER -