19-Year trends in mortality of patients hospitalized in the United States with high-risk pulmonary embolism

American Journal of MedicineStein PD, Matta F, Hughes PG, et al. | February 24, 2021

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Researchers analyzed the 19-year national trend in mortality of high-risk patients suffering from pulmonary embolism, to ascertain the impact of advanced therapy on mortality. In the US, hospitalization of 58,784 cases with a primary diagnosis of pulmonary embolism, that was high-risk, occurred from 1999-2017. A decline in mortality from 72.7% in 1999 to 49.8% in 2017 was evident in all high-risk patients. Most high-risk patients, 60.3% were managed with anticoagulants alone and did not receive an inferior vena cava filter. A reduction in mortality from 79.0% in 1999 to 55.7% in 2017 was evident in these patients. In 16.1% of high-risk patients, thrombolytic therapy was used, and open pulmonary embolectomy alone was employed in 4.3%, and 0.4% received extracorporeal membrane oxygenation. Overall, a reduction in mortality of high-risk patients with pulmonary embolism was revealed. The reduction was brought about by improved treatment of cases with shock and with cardiac arrest, and did not reflect advancements in therapy for pulmonary embolism.

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