Abstract
Introduction: Acute pulmonary embolism(PE) is known to be associated with significant short term and long term complications. However with evolution of PE management, the outcomes of PE related complications and need for readmission has not been well studied. Our aim of this study is to see the trend in readmissions in PE patients from the years 2010 to 2018. Methods: We utilized the National Readmission Database from 2010 to 2018 to identify hospitalized patients with a principal diagnosis of acute pulmonary embolism. Identified the total number of readmissions for acute PE from 2010 to 2018. Multivariate cox regression model was used to identify independent predictors of readmission. Results: The number of patients with 30-day readmissions have gradually increased from 14,508 in 2010 to 19,703 in 2018. The proportion of females admitted was higher than males in all years.The 30-day all cause readmission after principal admission for PE decreased from 11.2% to 9.7% from 2010 to 2014 but increased to 11.8% in 2018 (p<0.001). Risk adjusted readmission specific for PE showed a decrease from 1.2 to 1% (p=0.023) from 2010 to 2018, with the proportion decreasing from 11.9% to 9.5% during the same period. There was no significant difference in the inpatient mortality (p=0.382) and length of stay (p=0.658) during the study period. There was an increasing trend in the total hospital charges from 2010 (13,374$) to 2018 (15,104$) but the difference was not statistically different (p=0.086). Conclusion: Our study suggests that there is a statistically significant decrease in PE specific readmission, with a decrease followed by an increase in all-cause admission after a PE. There is also no significant difference in mortality and length of stay. These findings warrant further studies to elucidate the mechanism for decrease PE-specific readmission but possible causes for the increase in all-cause readmission in the hope of optimizing management and continuing improving outcomes.
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