Recent trends in clinical outcomes and resource utilization for pulmonary embolism in the United States: findings from the nationwide inpatient sample.
BACKGROUND
Pulmonary embolism (PE) has been cited as the most common preventable cause of death in hospitalized patients. The objectives of this study were to determine recent trends in clinical outcomes and resource utilization for hospitalized patients with a clinically recognized episode of acute PE.


METHODS
Patients with primary or secondary PE who had been discharged from US acute care hospitals were identified from the Nationwide Inpatient Sample during the 8-year period between 1998 and 2005. The major clinical outcomes assessed included hospital mortality and length of hospitalization. To assess resource utilization for the treatment of PE, average hospital charges for these admissions were assessed, normalized to 2005 US dollars, and adjusted to reflect the US consumer price index.


RESULTS
Between 1998 and 2005, the number of patients with primary or secondary PE on discharge from the hospital increased from 126,546 to 229,637; hospital case fatality rates for these patients decreased from 12.3 to 8.2% (p < 0.001); length of hospital stay decreased from 9.4 days to 8.6 days (p < 0.001); and total hospital charges increased from $25,293 to $43,740 (p < 0.001).


CONCLUSIONS
Between 1998 and 2005, significant improvements were observed in outcomes for patients hospitalized for clinically recognized PE, including decreases in mortality and length of hospital stay. Charges for this hospital care increased during this time period.
Park
Brian
B
Department of Surgery, University of Massachusetts Medical School, Worcester, MA.
Messina
Louis
L
Department of Surgery, University of Massachusetts Medical School, Worcester, MA.
Dargon
Phong
P
Department of Surgery, University of Massachusetts Medical School, Worcester, MA.
Huang
Wei
W
Division of Vascular Surgery, and Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA.
Ciocca
Rocco
R
Department of Surgery, Division of Vascular Surgery, Caritas St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA.
Anderson
Frederick A
FA
Division of Vascular Surgery, and Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA. Electronic address: fred.anderson@umassmed.edu.
D000368:Aged; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000191:economics* / Q000401:mortality* / Q000628:therapy; D016896:Treatment Outcome; D014481:United States; D020246:Venous Thrombosis / Q000150:complications / Q000517:prevention & control