Short-term outcomes of pulmonary embolism: A National Perspective

Authors

• Purav Shah, Department of Pulmonary and Critical Care Medicine, University of Florida, Gainesville, Florida.
• Shilpkumar Arora, Guthrie Robert Packer Hospital, Sayre, Pennsylvania.
• Varun Kumar, Department of Internal Medicine, Mount Sinai St. Luke's - West hospital, New York, New York.Follow
• Surina Sharma, Department of Internal Medicine, Mount Sinai St. Luke's - West hospital, New York, New York.
• Harshil Shah, Guthrie Robert Packer Hospital, Sayre, Pennsylvania.
• Byomesh Tripathi, Guthrie Robert Packer Hospital, Sayre, Pennsylvania.
• Purnima Sharma, Department of Internal Medicine, Mount Sinai St. Luke's - West hospital, New York, New York.
• Ravina Sharma, Department of Internal Medicine, Mount Sinai St. Luke's - West hospital, New York, New York.
• Sejal Savani, Department of Internal Medicine, Mount Sinai St. Luke's - West hospital, New York, New York.
• Muhammad Raheel Qureshi, Medstar Union Memorial Hospital, Baltimore, Maryland.
• Ibrahim Faruqi, Department of Pulmonary and Critical Care Medicine, University of Florida, Gainesville, Florida.

Document Type

Article

Abstract

BACKGROUND: Pulmonary embolism (PE) is associated with significant morbidity and mortality in hospitalized patients. Real time data on 90-day mortality, bleeding, and readmission is sparse. METHODS: The study cohort was derived from the National Readmission Data (NRD) 2013 to 2014. PE was identified using International Classification of Diseases, ninth Revision (ICD-9-CM) code 415.11/3/9 in the primary diagnosis field. Any admission within 90 days of primary admission was considered a 90-day readmission. Readmission etiologies were identified by ICD-9 code in the primary diagnosis field. Co-primary outcomes were 90-day readmission and 90-day mortality. RESULTS: We identified 260 614 patients with primary admission PE, 55 659 (21.36%) patients were readmitted within 90 days. Most of them were of old age (age ≥ 65 years: 49.04%) and females (52.78%). Among the etiologies of readmission pulmonary disorders (22.94%) (Including recurrent PE 7.33%), malignancies (8.31%), and bleeding disorders (6.75%) were the most important causes of 90-day readmissions. On multivariate analysis, higher readmission rates and 90 days mortality were seen in patients with heart failure, chronic pulmonary disease, Anemia, malignancy, and with higher Charlson score. Patients with longer length of stay during primary admission and who discharged to short/long-term facility were more likely get readmitted and die in 90 days. Paradoxically, obese patients showed an inverse relationship with co-primary outcomes. CONCLUSIONS: Older female patients were more likely to have a pulmonary embolism. High-risk groups such as heart failure, chronic pulmonary disease, anemia, and malignancy need to be given extra attention to prevent worse outcomes.

Medical Subject Headings

Adolescent; Adult; Aged; Aged, 80 and over; Female; Follow-Up Studies; Hospitalization (statistics & numerical data); Humans; Male; Middle Aged; Morbidity (trends); Population Surveillance; Pulmonary Embolism (diagnosis, epidemiology); Retrospective Studies; Risk Assessment; Risk Factors; Survival Rate (trends); Time Factors; United States (epidemiology); Young Adult

Publication Date

9-1-2018

Publication Title

Clinical cardiology

E-ISSN

1932-8737

Volume

41

Issue

9

First Page

1214

Last Page

1224

PubMed ID

30117162

Digital Object Identifier (DOI)

10.1002/clc.23048

Recommended Citation

Shah, Purav; Arora, Shilpkumar; Kumar, Varun; Sharma, Surina; Shah, Harshil; Tripathi, Byomesh; Sharma, Purnima; Sharma, Ravina; Savani, Sejal; Qureshi, Muhammad Raheel; and Faruqi, Ibrahim, "Short-term outcomes of pulmonary embolism: A National Perspective" (2018). Neurology. 2086.
https://scholar.barrowneuro.org/neurology/2086