Key result
In-hospital pulmonary thromboembolism occurred in 0.107% of patients overall, with a significantly lower incidence in patients undergoing surgery (0.095%) compared to those without surgery (0.119%).
Why the study?
Evidence regarding the development of pulmonary thromboembolism during hospitalization was unclear, and incidence was hypothesized to vary by clinical department.
Observational (n=4,684,659)
Yes
Absolute Event Rate: 0.095% vs 0.119%
p-value: p=<0.001
In-hospital pulmonary embolism occurs in approximately 0.1% of hospitalized patients, is associated with significantly prolonged hospital stays and higher mortality, and highlights the need for improved prophylactic measures, especially in non-surgical patients.
Non-surgical inpatients show higher PE incidence; leaves open optimal prophylaxis strategies pending prospective trials.
INTRODUCTION: Evidence regarding the development of pulmonary thromboembolism (PE) during hospitalization is unclear. We hypothesized that the incidence of PE could vary depending on clinical department and aimed to conduct a survey on the incidence of in-hospital PE. METHODS: We conducted a retrospective analysis using claims data of in-hospital patients in Japan. We collected background information regarding patients with and without PE occurrence during hospitalization. Further, we determined the incidence of PE and implemented prophylactic procedures in patients with and without surgery according to clinical department at admission. Finally, we examined the duration of hospital stay and in-hospital mortality rates in patients with and without PE. RESULTS: We found that 5007 (0.107%, 20.61 per 1000 person-years) patients developed PE during hospitalization and differed by clinical department at admission. Moreover, 2272 (0.095%, 19.3 per 1000 person-years) and 2735 (0.119%, 21.8 per 1000 person-years) patients with and without surgery, respectively, developed PE during hospitalization (P < 0.001). Further, 33.8% of inpatients underwent prophylactic procedures for PE; however, the implementation rate differed between patients with and without surgery (59.2% vs. 7.3%, P < 0.001). The median duration of hospital stay in patients with and without PE was 31.0 and 11.0 days, and the in-hospital mortality rates in patients with and without PE were 11.0% and 3.5%, respectively (P < 0.001). DISCUSSION: The incidence of in-hospital PE differed according to patient characteristics, clinical departments, and presence/absence of surgery. The onset of PE during hospitalization leads to prolonged hospital stay and in-hospital death. CONCLUSION: It is important to conduct a proper risk assessment on admission as well as to implement proper prophylactic procedures to prevent the development of PE during hospitalization.
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Imura et al. (2022) conducted an observational in Hospitalized patients without prior DVT/PE (n=4,684,659). Surgery during hospitalization vs. No surgery was evaluated on Incidence of in-hospital pulmonary thromboembolism (p=<0.001). In-hospital pulmonary thromboembolism occurred in 0.107% of patients overall, with a significantly lower incidence in patients undergoing surgery (0.095%) compared to those without surgery (0.119%).
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