Do social determinants of health (race/ethnicity, income, payer type) affect the use of advanced therapies and in-hospital mortality in adults with acute pulmonary embolism?
Social inequities, including non-White race and low socioeconomic status, are associated with decreased utilization of advanced therapies and higher in-hospital mortality in patients with acute pulmonary embolism.
Background: The role of social determinants in the treatment and course of acute pulmonary embolism (PE) is understudied. Objective: To investigate the association between social determinants of health with in-hospital management and early clinical outcomes following acute PE. Methods: We identified hospitalizations of adults with acute PE discharge diagnosis from the nationwide inpatient sample (2016-2018). Multivariable regression was used to investigate the association between race/ethnicity, type of expected primary payer, and income with the use of advanced PE therapies (thrombolysis, catheter-directed treatment, surgical embolectomy, extracorporeal membrane oxygenation), length of stay, hospitalization charges, and in-hospital death. Results: , 1.09; 95% CI, 1.02-1.17). Among high-risk PE, patients of other than the White race had the highest in-hospital mortality. Conclusion: We observed inequalities in advanced therapies used for acute PE and higher in-hospital mortality in races other than White. Low socioeconomic status was also associated with lesser use of advanced treatment modalities and greater in-hospital mortality. Future studies should further explore and consider the long-term impact of social inequities in PE management.
Farmakis et al. (Wed,) studied this question.