F-27 | Clinical Outcomes for Patients with Peripheral Arterial Disease who underwent Catheter-Directed Thrombolysis for Pulmonary Embolism: An Analysis of the National Inpatient Sample

Catheter-directed thrombolysis (CDT) for pulmonary embolism (PE) is considered one of the most recent therapy options for massive and submassive PE with hemodynamic instability. There is limited data available on the impact of peripheral arterial disease (PAD) on PE patients who underwent CDT. We sought to examine the national inpatient sample database to describe in-hospital outcomes among these patients. Methods: Data were extracted from the National Inpatient Sample (NIS) Database for the years 2019 and 2020. The NIS was searched for hospitalizations of adult PE patients who underwent CDT with and without a concomitant diagnosis of PAD using international classification of diseases 10th revision codes. Multivariate logistic was used to adjust for confounders. The primary outcome was inpatient mortality. Secondary outcomes were hospital length of stay (LOS), and total hospital charges (TOTHCG). SPSS software was used for statistical analysis. Results: This study included 4641 PE patients who underwent CDT, of which 365 (7. 9%) patients had PAD. PE patients with PAD who underwent CDT had higher prevalence of hypertension (12. 7% Vs 10. 4%, p<0. 001), hyperlipidemia (8. 5% Vs 7. 3%, p <0. 001), and diabetes mellitus (10. 3% Vs 9. 7%, p<0. 001) compared to those without PAD. In-hospital mortality was higher among the patients with PAD (7. 4% Vs 5. 4%, p< 0. 001). Multivariate regression showed that PE patients with PAD who underwent CDT had higher inpatient mortality (OR 1. 089, CI 1. 047-1. 132, p<0. 001) in addition to paying significantly more TOTHCG (170, 339 Vs 151, 012, p<0. 001). The mean LOS was longer among the patients with PAD (10. 3 days vs 8. 4 days, p<0. 001). On secondary analysis, it has shown that PE patients with PAD who underwent CDT had higher odds of having arrhythmias (OR 1. 075, CI 1. 052-1. 097, p<0. 001), shock (OR 1. 121, CI 1. 082-1. 162, p<0. 001), and pressor requirements (OR 1. 116, CI 1. 046-1. 190, p<0. 001) compared to those without PAD. Conclusions: In this nationally representative population-based retrospective cohort study, PAD was associated with higher mortality and worse outcomes among pulmonary embolism patients who underwent catheter-directed thrombolysis. K. Girgis, R. Beshai, T. Elias, T. Roy, M. Daneshvar, H. Weinberg, Nothing to disclose.