Compared to catheter-directed thrombolysis, surgical embolectomy was associated with higher average costs (+$46,156; p<0.001), while anticoagulation was less expensive (-$9,707; p<0.001).
Observational (n=1,375,419)
Yes
How do different treatment modalities affect cost and length of stay in inpatients with pulmonary embolism?
Substantial cost and length of stay disparities exist among pulmonary embolism treatment modalities, with surgical embolectomy being the most expensive and anticoagulation the least expensive.
p-value: p=<0.001
ABSTRACTIntroduction Systematic assessment of resource utilization in cost-intensive diseases such as pulmonary embolism (PE) is important to optimize health system efficiency. We examined the association between treatment modality, cost, and length of stay among inpatients diagnosed with PE. Methods Using the National Inpatient Sample (1998-2021), we performed a retrospective trend analysis. Inpatient charges were converted to costs using the cost-to-charge ratio. Average cost differences, between catheter-directed thrombolysis, anticoagulation, systemic thrombolysis, catheter-directed embolectomy, and surgical embolectomy, were assessed using survey-weighted linear regressions, with hospital clustering. Differences in median length of stay, by treatment modality, were modeled using quantile regression. Results The sample included 1, 375, 419 admissions. 1, 338, 332 (97. 3%) received anticoagulation; 22, 934 (1. 7%) underwent systemic thrombolysis; 8, 363 (0. 6%) underwent catheter-directed thrombolysis; 3, 453 (0. 3%) underwent catheter-directed embolectomy; and 2, 337 (0. 2%) underwent surgical embolectomy. Compared to catheter-directed thrombolysis surgical embolectomy, catheter-directed embolectomy, and systemic thrombolysis were associated with higher average costs (surgical embolectomy=+46, 156; catheter-directed embolectomy=+9, 042; systemic thrombolysis=+3, 094, respectively; all pConclusion Substantial cost disparities exist among PE treatment modalities, spanning thousands of dollars. Although catheter-directed embolectomy was associated with the shortest median length of stay, the least expensive treatment modality was anticoagulation while the most expensive was surgical embolectomy. These insights offer guidance for optimizing resource allocation strategies in managing this prevalent postoperative complication.
Cuartas et al. (2026) conducted an observational in Pulmonary embolism (n=1,375,419). Treatment modalities (catheter-directed thrombolysis, anticoagulation, systemic thrombolysis, catheter-directed embolectomy, surgical embolectomy) vs. Catheter-directed thrombolysis was evaluated on Average cost differences and median length of stay (p=<0.001). Compared to catheter-directed thrombolysis, surgical embolectomy was associated with higher average costs (+$46,156; p<0.001), while anticoagulation was less expensive (-$9,707; p<0.001).