Society for Clinical Vascular Surgery
December 17, 2007

An Assessment of Recent Trends in the Management of Pulmonary Embolism in United States from 2000 to 2005: Findings from the Nationwide Inpatient Sample

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Brian D. Park, MD, Louis M. Messina, MD, Rocco G. Ciocca, MD, Fred A. Anderson, PhD.
UMASS Medical School, Worcester, MA, USA.

Objective:
Pulmonary embolism (PE) has been cited as the most common preventable cause of death in hospitalized US patients. The objective of this study was to determine the impact of recent, nationwide efforts to improve clinical outcomes and resource utilization for hospital patients with a clinically recognized episode of acute PE.
Methods:
Patients discharged from US acute care hospitals with a primary diagnosis of PE were identified from the Nationwide Inpatient Sample (NIS) during the 6 year period 2000 to 2005. Year-on-year cases of clinically recognized PE were analyzed to determine annual US trends in the frequency of clinically recognized PE. Major clinical outcomes assessed included length of stay and in-hospital mortality. To assess resource utilization in the treatment of PE, average hospital charges for these admissions were also assessed.
Results:

Year200020012002200320042005p-value
Number of Patients87,85799,066111,663121,132127,031137,451
Mortality5.9%5.8%5.0%4.6%4.4%3.7%<0.0001
LOS (days)6.96.66.76.56.46.2<0.0001
Average Charges$18,864$19,949$23,297$24,957$26,045$27,596<0.0001

Conclusion:
Between 2000 and 2005, significant improvements were seen in outcomes for patients hospitalized with clinically recognized PE, including decreases in mortality and length of hospital stay. These results suggest that evolving treatment strategies for PE during the last 6 years are leading to improved outcomes. Increases in charges for this hospital care during this time period appear justified by improved patient outcomes.
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