Pulmonary Vascular Disease |

Pulmonary Embolism Trends From 1996 to 2010 FREE TO VIEW

Sean Smith, MD; Jeffrey Geske, MD; David McNamara, MD; Grant Waterer, MD; Richard Wunderink, MD
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Northwestern University, Chicago, IL

Chest. 2013;144(4_MeetingAbstracts):850A. doi:10.1378/chest.1704692
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SESSION TITLE: DVT/PE/Pulmonary Hypertension Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: Pulmonary embolism (PE) is a common condition requiring hospital admission with significant associated morbidity and mortality. Trends in PE incidence, mortality, and hospital outcomes have not been fully described at a national level.

METHODS: We queried the Nationwide Inpatient Sample, a weighted survey of hospital admissions prepared by the Healthcare Cost and Utilization Project (HCUP) and Agency for Healthcare Research and Quality. The study is exempt from Institutional Review Board assessment as all data was publically available and de-identified. All authors participated in HCUP training per protocol. PE cases were selected via a query for hospitalization with a 9th revision International Classification of Diseases (ICD-9) principal diagnosis code of 415.19. Number of admissions, median charges, median length-of-stay (LOS), and all-cause mortality rates were determined from 1996 to 2010. Admissions were adjusted annually for US population and reported in cases per 100,000 population. Charges were adjusted annually by the Consumer Price Index for 2010 dollars.

RESULTS: In 1996, 69,266 (25.7/100,000) admissions were for PE, which increased yearly to 171,613 (55.5/ 100,000) in 2010. Given this increase, PE has climbed from the 84th most common reason for admission in 1997 to the 36th most common in 2010. Median hospital LOS, 7 days in 1996, decreased to 5 days by 2010. Paralleling LOS, hospital mortality fell from 7.01% in 1996 to 3.06% in 2010. Despite shorter LOS, median adjusted hospital charges increased from $15,406 in 1996 to $24,325 in 2010, accounting for an estimated $4.17 billion in hospital charges in 2010.

CONCLUSIONS: PE is an increasingly common reason for hospital admission and is associated with significant healthcare costs. Although PE hospitalizations are more frequent, LOS and mortality are steadily falling.

CLINICAL IMPLICATIONS: We hypothesize that more subsegmental PE are being diagnosed with the advent of CT angiography, and that care is transitioned to the outpatient setting more expediently with low-molecular weight heparins.

DISCLOSURE: The following authors have nothing to disclose: Sean Smith, Jeffrey Geske, David McNamara, Grant Waterer, Richard Wunderink

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