In-hospital mortality for pulmonary embolism was 3.7%, with systemic thrombolysis (OR 8.47), metastatic cancer (OR 3.22), and age ≥75 (OR 3.05) identified as the strongest predictors of death.
In a large New York state cohort, pulmonary embolism was associated with a 3.7% in-hospital mortality rate, with older age, specific comorbidities, and systemic thrombolysis use identified as significant predictors of death.
Absolute Event Rate: 0% vs 0%
Introduction: Pulmonary embolism (PE) is a significant cause of morbidity and mortality in the US. We aimed to explore the hospital mortality and endovascular therapy use among patients with PE and investigate the associated potential risk factors. Methods: Retrospective study based on data from the State Inpatient Database (SID), New York, 2017. We used the tenth revision of the International Classification of Diseases, Clinical Modification codes (ICD-10-CM) to identify patients admitted with a primary diagnosis of PE (ICD-10-CM codes I26.02, I26.09, I26.92, I26.93, I26.94, I26.99). We selected patients who underwent endovascular therapy (EVT), including systemic thrombolysis, catheter-tip thrombolysis, and pulmonary embolectomy. The primary outcomes studied were in-hospital mortality and EVT use. Results: From the SID 2017, there were 10,129 PE hospitalizations, with a mean age of 62 years. Of these patients, 270 (2.7%) underwent systemic thrombolysis, 236 (2.3%) underwent catheter-tip thrombolytics, and 52 (0.5%) underwent pulmonary thrombectomy. The in-hospital mortality rate overall was 3.7%. Factors associated with in-hospital mortality were age 65-74 (OR 2.54, CI: 1.49 – 4.35) and age ≥75 (OR 3.05, CI: 1.76 – 5.30), diabetes (OR 1.30, CI: 1.01 – 1.68), peripheral vascular disease (OR 1.86, CI: 1.27 – 2.74), chronic kidney disease (OR 2.31, CI: 1.63 - 3.28), myocardial infarction (OR 2.83, CI: 1.81 – 4.43), metastatic cancer (OR 3.22; CI: 2.48 – 4.19), atrial fibrillation (OR 2.23; CI: 1.71 – 2.90). For EVT, the use of systemic thrombolysis was associated with increased risk of mortality (OR 8.47, CI: 5.93 – 12.12). Predictors associated with increased odds of EVT were age 45-54 (OR 1.70, CI: 1.17 – 2.49), atrial fibrillation (OR 2.01, CI: 1.44 – 2.82), and obesity (OR 2.36, CI: 1.83 – 3.03). Hospital admissions for PE were higher in Kings County compared to other counties in New York City. Conclusions: Patients with PE had a high in-hospital mortality in New York. There are several independent predictors of increased mortality in these patients. Clinical awareness/modification of these predictors could decrease the mortality rate among patients with PE.
Ukenenye et al. (Sun,) reported a other. In-hospital mortality for pulmonary embolism was 3.7%, with systemic thrombolysis (OR 8.47), metastatic cancer (OR 3.22), and age ≥75 (OR 3.05) identified as the strongest predictors of death.