title: Factors Influencing Hospital Stay for Pulmonary Embolism. A Cohort Study.
abstract: BACKGROUND
  The aim of this study was to identify factors influencing hospital stay due to pulmonary embolism.
  
  
  METHODS
  We performed a retrospective cohort study of patients hospitalized between 2010 and 2015. Patients were identified using information recorded in hospital discharge reports (ICD-9-CM codes 415.11 and 415.19).
  
  
  RESULTS
  We included 965 patients with a median stay of 8 days (IQR 6-13 days). Higher scores on the simplified Pulmonary Embolism Severity Index (sPESI) were associated with increased probability of longer hospital stay. The probability of a hospital stay longer than the median was 8.65 (95% CI 5.42-13.79) for patients referred to the Internal Medicine Department and 1.54 (95% CI 1.07-2.24) for patients hospitalized in other departments, compared to those referred to the Pneumology Department. Patients with grade 3 on the modified Medical Research Council dyspnea scale had an odds ratio of 1.63 (95% CI: 1.07-2.49). The likelihood of a longer than median hospital stay was 1.72 (95% CI: 0.85-3.48) when oral anticoagulation (OAC) was initiated 2-3 days after admission, and 2.43 (95% CI: 1.16-5.07) when initiated at 4-5 days, compared to OAC initiation at 0-1 days.
  
  
  CONCLUSIONS
  sPESI grade, the department of referral from the Emergency Department, the grade of dyspnea and the time of initiating OAC were associated with a longer hospital stay.
authors.affiliation: Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España.
authors.forename: Nuria
authors.initials: N
authors.lastname: Rodríguez-Núñez
authors.affiliation: Departamento de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, España; CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, España; Grupo de Epidemiología, Salud Pública y Evaluación de Servicios de Salud, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España. Electronic address: alberto.ruano@usc.es.
authors.forename: Alberto
authors.initials: A
authors.lastname: Ruano-Raviña
authors.affiliation: Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España.
authors.forename: Romina
authors.initials: R
authors.lastname: Abelleira
authors.affiliation: Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España; Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España.
authors.forename: Lucía
authors.initials: L
authors.lastname: Ferreiro
authors.affiliation: Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España.
authors.forename: Adriana
authors.initials: A
authors.lastname: Lama
authors.affiliation: Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España; Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: González-Barcala
authors.affiliation: Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España.
authors.forename: Antonio
authors.initials: A
authors.lastname: Golpe
authors.affiliation: Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España.
authors.forename: María E
authors.initials: ME
authors.lastname: Toubes
authors.affiliation: Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España; Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España.
authors.forename: José M
authors.initials: JM
authors.lastname: Álvarez-Dobaño
authors.affiliation: Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España; Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España.
authors.forename: Luis
authors.initials: L
authors.lastname: Valdés
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D015331:Cohort Studies; D015897:Comorbidity; D004417:Dyspnea / Q000209:etiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006748:Hospital Departments / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007388:Internal Medicine; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011655:Pulmonary Embolism / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D015272:Pulmonary Medicine; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013030:Spain; D055815:Young Adult
chemical_list: D000925:Anticoagulants
keywords: Disnea; Dyspnea; Embolia pulmonar; Estancia hospitalaria; Hospital stay; Inicio de anticoagulación oral; Initiation of oral anticoagulation; Pulmonary Embolism Severity Index simplificado (sPESI); Pulmonary embolism; Simplified Pulmonary Embolism Severity Index (sPESI)