Correlates of In-Hospital Deaths among Hospitalizations with Pulmonary Embolism: Findings from the 2001−2008 National Hospital Discharge Survey
Open Access
- 6 July 2012
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 7 (7), e34048
- https://doi.org/10.1371/journal.pone.0034048
Abstract
Deep vein thrombosis and pulmonary embolism (PE) are responsible for substantial mortality, morbidity, and impaired health-related quality of life. The aim of this study was to evaluate the correlates of in-hospital deaths among hospitalizations with a diagnosis of PE in the United States. By using data from the 2001−2008 National Hospital Discharge Survey, we assessed the correlates of in-hospital deaths among 14,721 hospitalizations with a diagnosis of PE and among subgroups stratified by age, sex, race, days of hospital stay, type of admission, cancer, pneumonia, and fractures. We produced adjusted rate ratios (aRR) and 95% confidence intervals using log-linear multivariate regression models. Regardless of the listing position of diagnostic codes, we observed an increased likelihood of in-hospital death in subgroups of hospitalizations with ages 50 years and older (aRR = 1.82−8.48), less than 7 days of hospital stay (aRR = 1.43−1.57), cancer (aRR = 2.10−2.28), pneumonia (aRR = 1.79−2.20), or fractures (aRR = 2.18) (except for first-listed PE), when compared to the reference groups with ages 1−49 years, 7 days or more of hospital stay, without cancer, pneumonia, or fractures while adjusting for covariates. In addition, we observed an increased likelihood of in-hospital death for first-listed PE in hospitalizations of women, when compared to those of men (aRR = 1.45). The results of this study provide support for identifying, developing, and implementing effective, evidence-based clinical assessment and management strategies to reduce PE-related morbidity and mortality among hospitalized PE patients who may have concurrent health conditions including cancer, pneumonia, and fractures.Keywords
This publication has 42 references indexed in Scilit:
- Thrombolytic Therapy in Unstable Patients with Acute Pulmonary Embolism: Saves Lives but UnderusedAmerican Journal Of Medicine, 2012
- Time Trends in Pulmonary Embolism in the United StatesArchives of Internal Medicine, 2011
- Incidence and risk factors for fatal pulmonary embolism after major trauma: a nested cohort studyBritish Journal of Anaesthesia, 2010
- Acute Pulmonary EmbolismNew England Journal of Medicine, 2010
- Pulmonary Embolism Incidence Is Increasing with Use of Spiral Computed TomographyAmerican Journal Of Medicine, 2008
- Acute Pulmonary EmbolismNew England Journal of Medicine, 2008
- The Epidemiology of Venous Thromboembolism in the CommunityArteriosclerosis, Thrombosis, and Vascular Biology, 2008
- Multimorbidity's many challengesBMJ, 2007
- Epidemiology and Risk Factors for Venous ThrombosisSeminars in Hematology, 2007
- Clinical Practice Guidelines and Quality of Care for Older Patients With Multiple Comorbid DiseasesJAMA, 2005