Utilization trends and outcomes of catheter-directed thrombolysis for pulmonary embolism in the US by race/ethnicity.

Male Humans Female Thrombolytic Therapy / adverse effects Fibrinolytic Agents Ethnicity Treatment Outcome Pulmonary Embolism Hemorrhage / chemically induced Catheters Retrospective Studies
Bleeding CDT Ethnicity Mortality Outcomes Trends

Journal

Journal of thrombosis and thrombolysis
ISSN: 1573-742X
Titre abrégé: J Thromb Thrombolysis
Pays: Netherlands
ID NLM: 9502018

Informations de publication

Date de publication:
Nov 2022
Historique:
accepted: 12 09 2022
pubmed: 12 10 2022
medline: 2 11 2022
entrez: 11 10 2022
Statut: ppublish

Résumé

Contemporary data on catheter-directed thrombolysis (CDT) utilization trends and associated hospital outcomes in pulmonary embolism (PE) n the US is limited. Using the nationwide inpatient sample database, we identified patients hospitalized for acute PE treated with CDT from January 1, 2008, to December 31, 2018. Cochrane-Armitage test was used to evaluate the temporal trends in utilization, hospital mortality, and major bleeding rates. Multivariate logistic regression was used to compare differences in the outcomes across race/ethnicity, 4444 patients (unweighted hospitalizations) underwent CDT during the study period. The mean age ± standard deviation of the population was 58 ± 16 years and the majority were males (54%). 3269 (73.6%) patients were non-Hispanic White (NHW), 802 (18.0%) patients were non-Hispanic Black (NHB), and 373 (8.4%) patients were of 'other' races/ethnicities. There was a more than tenfold increase in CDT use in 2018 compared to 2008. The total mortality and bleeding rates were approximately 7 and 10% respectively. Hospital mortality rates trended down across all races/ethnicities during the study period. A similar downward trend in bleeding rates was noted in NHB only (28.6% vs 10.7%, p = 0.04). In-hospital mortality and major bleeding odds were comparable across all races/ethnicities were comparable. NHB patients and other races were more likely to require blood transfusion and incur higher hospitalization costs compared with NHW patients. CDT use increased significantly in the US during the study period with a corresponding downward trend in in-hospital mortality across all races, and bleeding rates in NHB.

Identifiants

DOI: 10.1007/s11239-022-02710-9 PMID: 36219337
pubmed: 36219337
doi: 10.1007/s11239-022-02710-9
pii: 10.1007/s11239-022-02710-9
doi:

Substances chimiques

Fibrinolytic Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

675-685

Informations de copyright

© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Auteurs

Titilope Olanipekun (T)

Department of Hospital Medicine, Covenant Health System, Knoxville, TN, 37922, USA. titilope_olanipekun@teamhealth.com.
Department of Internal Medicine, Morehouse School of Medicine, 720, Westview Drive, SW, Atlanta, GA, 30310, USA. titilope_olanipekun@teamhealth.com.
ORCID: 0000-0002-8472-6970

Temidayo Abe (T)

Department of Internal Medicine, Morehouse School of Medicine, 720, Westview Drive, SW, Atlanta, GA, 30310, USA.

Valery Effoe (V)

Department of Cardiovascular Medicine, Morehouse School of Medicine, Atlanta, GA, USA.

Abimbola Chris-Olaiya (A)

Department of Critical Care Medicine, Cleveland Clinic Respiratory Institute, Cleveland, OH, USA.

Isaac Biney (I)

Department of Pulmonary and Critical Care Medicine, University of Tennessee Medical Center, Knoxville, TN, USA.

Pramod Guru (P)

Department of Critical Care Medicine, Mayo Clinic, Jacksonville, FL, USA.

Charles Ritchie (C)

Department of Interventional Radiology, Mayo Clinic, Jacksonville, FL, USA.

Devang Sanghavi (D)

Department of Critical Care Medicine, Mayo Clinic, Jacksonville, FL, USA.

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questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Utilization trends and outcomes of...
questionsmedicales.fr › Thérapeutique › Traitement médicamenteux › Traitement thrombolytique › Utilization trends and outcomes of...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents hématologiques › Fibrinolytiques › Utilization trends and outcomes of...
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