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Short term outcomes of Pulmonary Embolism: A National Perspective.
Clin Cardiol. 2018 Aug 17;:
Authors: Shah P, Arora S, Kumar V, Sharma S, Shah H, Tripathi B, Sharma P, Sharma R, Savani S, Qureshi MR, Faruqi I
Abstract
OBJECTIVE: Pulmonary embolism (PE) is associated with significant morbidity and mortality in hospitalized patients. Real time data on 90-day mortality, bleeding and readmission is sparse.
METHODS: The study cohort was derived from the National Readmission Data (NRD) 2013-14. Pulmonary embolism was identified using International Classification of Diseases, 9th Revision (ICD-9-CM) code 415.11/3/9 in the primary diagnosis field. Any admission within 90 days of primary admission was considered a 90-day readmission. Readmission etiologies were identified by ICD-9 code in the primary diagnosis field. Co-primary outcomes were 90-day readmission and 90-day mortality.
RESULTS: We identified 260,614 patients with primary admission PE, 55,659 (21.36%) patients were readmitted within 90 days. Most of them were of old age (age ≥65 years: 49.04%) and females (52.78%). Among the etiologies of readmission pulmonary disorders (22.94%) (Including recurrent PE 7.33%), malignancies (8.31%) and bleeding disorders (6.75%) were the most important causes of 90-day readmissions. On multivariate analysis, higher readmission rates and 90 days mortality were seen in patients with heart failure, chronic pulmonary disease, Anemia, malignancy and with higher Charlson score. Patients with longer length of stay during primary admission and who discharged to short/long term facility were more likely get readmitted and die in 90 days. Paradoxically, obese patients showed an inverse relationship with co-primary outcomes.
CONCLUSIONS: Older female patients were more likely to have a pulmonary embolism. High-risk groups such as heart failure, chronic pulmonary disease, anemia and malignancy need to be given extra attention to prevent worse outcomes. This article is protected by copyright. All rights reserved.
PMID: 30117162 [PubMed - as supplied by publisher]