Open AccessShort‐term outcomes of pulmonary embolism: A National Perspective
Author(s) -
Shah Purav,
Arora Shilpkumar,
Kumar Varun,
Sharma Surina,
Shah Harshil,
Tripathi Byomesh,
Sharma Purnima,
Sharma Ravina,
Savani Sejal,
Qureshi Muhammad Raheel,
Faruqi Ibrahim
Publication year - 2018
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.23048
Subject(s) - medicine , pulmonary embolism , etiology , heart failure , diagnosis code , malignancy , anemia , cohort , comorbidity , pulmonary hypertension , pediatrics , population , environmental health
Background 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 to 2014. PE was identified using International Classification of Diseases, ninth 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.