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Data regarding the incidence of pulmonary embolism (PE), its management and outcomes remains limited over the last decade. The aim of our study was to review the national rates of PE and its outcomes.
We performed a 12 year (2004-2015) analysis of the National Inpatient Sample database. Patients with a diagnosis of acute pulmonary embolism (PE) were identified. Major PE was defined as PE with associated mechanical ventilation, vasopressor need, or non septic shock. Outcomes measures were surgical embolectomy, catheter directed thrombolysis (CDT), and overall mortality.
A total of 713,083 patients were diagnosed with acute PE during the study period of which 8.6% were major PE. The rate of acute PE increased from 5.3 per 1000 hospital admissions in 2004 to 9.7 per 1000 hospital admissions in 2015 (p<0.001). The rate of major PE increased from 7.9% to 9.7% (p<0.001). The rate of surgical embolectomy was 0.2% and remained unchanged (p=0.47), and there was a 5-fold increase in the rate of CDT (0.2% in 2004 vs. 1.0% in 2015; p<0.001). There was a significant decrease in mortality for PE (8.9% in 2004 vs. 6.4% in 2015; p<0.001) as well as surgical mortality for embolectomy (32.4% in 2004 vs. 14.0% in 2015; p<0.001).
The incidence of acute PE and major PE has been increasing. There has been an increase in the use of CDT, while the rate of surgical embolectomy has remained unchanged. However, the mortality associated with acute PE and surgical embolectomy has significantly improved.
Sunday, March 17, 2019, 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 Venous Thrombo-embolic Disease
Presentation Number: 902-12
- 2019 American College of Cardiology Foundation