title: Pulmonary embolism, acute coronary syndrome and ischemic stroke in the Spanish National Discharge Database.
abstract: BACKGROUND
  Venous and arterial thrombosis share a number of pathogenic mechanisms, but the burden of pulmonary embolism (PE) has not been consistently compared with that in other arterial diseases.
  
  
  METHODS
  We used the Spanish National Discharge Database to compare the frequency, clinical characteristics and mortality rate of all patients with PE, acute coronary syndrome (ACS) or ischemic stroke admitted from 2001 to 2010. Patients were classified as having primary diagnosis (the process leading to hospital admission) or secondary diagnosis (it appeared during hospital stay for other reasons)
  
  
  RESULTS
  During the study period, 31,949,739 patients were discharged. Of these, 165,229 (0.52%) were diagnosed with PE, 562,837 (1.76%) with ACS and 495,427 (1.55%) with ischemic stroke. Overall, 31% of patients with PE, 8.4% with ACS and 13% with ischemic stroke had secondary diagnoses. The most common reasons for admission in patients with secondary PE were: cancer (21%), acute respiratory failure (11%), acute heart failure (6.4%) and stroke (5.5%). Mean hospital stay was: 14 ± 13 days in PE patients, 9.7 ± 9.7 in those with ACS and 13 ± 14 days in those with stroke. In-hospital mortality rate was: 10.5%, 10.1% and 12.3% respectively in patients with primary diagnosis, and 36%, 34% and 29% in those with secondary diagnosis.
  
  
  CONCLUSIONS
  Patients hospitalized with PE were 3-4 times less frequent than those with ACS or stroke, but had a higher mortality. One in every 3 patients with PE (but only one in every 10 with ACS or stroke) had secondary diagnosis, and these patients had the highest mortality.
authors.affiliation: Department of Internal Medicine, Hospital Carlos Haya, Málaga, Spain.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Guijarro
authors.affiliation: Pneumology Department, Hospital General Universitario Gregorio Marañon, Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: de Miguel-Diez
authors.affiliation: Respiratory Department, Ramón y Cajal Hospital, IRYCIS, Madrid, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Jimenez
authors.affiliation: Department of Internal Medicine, Santa Lucía Hospital, Cartagena, Murcia, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Trujillo-Santos
authors.affiliation: Department of Internal Medicine, University Hospital Virgen del Rocío, Sevilla, Spain.
authors.forename: Remedios
authors.initials: R
authors.lastname: Otero
authors.affiliation: Department of Internal Medicine, Hospital Rey Juan Carlos, Móstoles, Madrid, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Barba
authors.affiliation: Universidad Católica de Murcia, Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. Electronic address: mmonreal.germanstrias@gencat.cat.
authors.forename: Manuel
authors.initials: M
authors.lastname: Monreal
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology* / Q000401:mortality; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D011655:Pulmonary Embolism / Q000453:epidemiology* / Q000401:mortality; D012131:Respiratory Insufficiency / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality
keywords: Acute coronary syndrome; Ischemic stroke; Mortality; Prevention; Pulmonary embolism