F-21 | Clinical Outcomes for Catheter-Directed Thrombolysis for Pulmonary Embolism in Octogenarians, Nonagenarians, and Centenarians: A retrospective cohort study

Catheter directed therapy (CDT) has been established as a therapeutic option for acute pulmonary embolism (PE). There is limited data available on the impact of CDT for PE procedure among the older population. 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 using international classification of diseases 10th revision codes. We then examined the outcomes in patients who were older than or equal to 80 years old (YO) Vs younger than 80 years old. Linear regression and multivariate logistics were used accordingly 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 473 (10. 2%) were older population. Older PE patients ≥ 80 YO, who underwent CDT, had higher prevalence of hypertension (11. 6% Vs 10. 4%, p<0. 001) and chronic kidney disease (6. 4% Vs 4. 5%, p<0. 001) compared to younger patients. In-hospital mortality was higher among the older population (7. 9% Vs 5. 4% p< 0. 001). Multivariate regression showed that older patients who underwent CDT for PE had higher inpatient mortality (OR 1. 249, CI 1. 169-1. 333, p<0. 001). On linear regression analysis, increased age was associated with increased in-hospital mortality (p<0. 001). It was also shown that older PE patients who underwent CDT had more TOTHCG (159, 400 Vs 151, 012, p<0. 001) in addition to longer LOS (12. 1 days Vs 8. 4 days, p<0. 001). On secondary analysis, it has shown that older PE patients who underwent CDT had higher odds of having arrhythmias (OR 1. 157, CI 1. 122-1. 193, p<0. 001), shock (OR 1. 104, CI 1. 068-1. 141, p<0. 001), and pressor requirements (OR 1. 128, CI 1. 054-1. 207, p<0. 001). Conclusions: In this nationally representative population-based retrospective cohort study, CDT for PE was associated with higher mortality and worse outcomes among older patients. R. Beshai, K. Girgis, T. Elias, T. Roy, M. Daneshvar, H. Weinberg, Nothing to disclose.