Author + information
- Srinath Adusumallia,b,
- Bram Gellera,b,
- Lin Yanga,b,
- Jay Giria,b,
- Peter Groenevelda,b and
- Cardiovascular Outcomesa,b
Background: There are ∼100,000 acute pulmonary embolism (PE) deaths annually in the United States, accounting for ∼25% of patients presenting with sudden death. Catheter-directed thrombolysis (CDT) and systemic thrombolysis (ST) are often used to treat intermediate/high-risk PEs, although the data supporting the use of CDT is sparse. The trends in utilization of CDT and ST have not been well described, at least in part due to the lack of specific procedural coding in other administrative datasets.
Methods: From the OptumInsight national commercial insurance claims database, we identified 100,744 patients hospitalized with PE between 2004 and 2014. We searched all administrative claims from these hospitalizations to ascertain use of CDT/ST and compared trends in treatment utilization. The Mann-Kendall test was used to assess for a statistically significant change in the use of CDT/ST over time.
Results: Of the 100,744 admissions for PE, 2,175 patients (2.2%) received either CDT (n=761) or ST (n=1414). From 2004 to 2014, the number of PE hospitalizations increased by 306% (p<0.001). Over the same 10-year period, the number of PE patients treated with CDT increased by 197% (p=0.001) and the number treated with ST increased by 514% (p<0.001).
Conclusion: There was a significant increase in the number of PE patients treated with both ST and CDT over the last decade despite a lack of evidence supporting CDT. Evidence of clinical safety and effectiveness is needed to continue to justify the role of CDT in PE therapy.
Room 147 B
Saturday, March 18, 2017, 9:04 a.m.-9:14 a.m.
Session Title: Highlighted Original Research: Pulmonary Hypertension and Venous Thrombo-embolic Disease and the Year in Review
Abstract Category: 35. Pulmonary Hypertension and Pulmonary Thrombo-embolic Disease
Presentation Number: 904-12
- 2017 American College of Cardiology Foundation