IMPACT OF CHRONIC LUNG DISEASE ON IN-HOSPITAL OUTCOMES FOR PATIENTS ADMITTED WITH A PULMONARY EMBOLUS

Abstract

SESSION TITLE: Tuesday Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/22/2019 01:00 PM - 02:00 PM PURPOSE: Several studies have suggested that chronic lung diseases (CLD) such as asthma and COPD are associated with a higher risk of developing a pulmonary embolism (PE). While much effort is focused on overcoming diagnostic challenges in patients with known lung conditions and concurrent PE, the data for short term in hospital outcomes is scarce. The aim of this study was to explore the impact of CLD on length of stay, total inpatient charges and in-hospital mortality in this population of patients presenting with PE. METHODS: This retrospective cohort study utilized data from the Nationwide Inpatient Sample (NIS) to identify adult patients (18+ years) from 2012-2015 who had been diagnosed with PE using the International classification of Diseases, Ninth Revision; Clinical modification (ICD9) codes. ICD9 codes were also used to identify patients with CLD as defined by the Elixhauser Comorbidity measures. Hospital length of stay (LOS), total inpatient charges, inpatient mortality, and average age at admission were assessed. ICD9 codes were also used to exclude patients with missing important clinical identifiers (age, gender, death, race). Encounters were separated into two groups: PE without CLD and PE with CLD, and compared using Chi-squared and independent t-tests. RESULTS: There were 212,330 encounters identified with a diagnosis of PE who met the inclusion criteria. Of these patients, 199,332 (93.9%) had a diagnosis of chronic pulmonary disease. The group with PE and concurrent chronic pulmonary disease had a significantly higher mortality (1.5% vs 5.9% p=0.000), as well as increased length of stay (4.11 vs 6.93 days p=0.000) and larger amount of total inpatient charges accumulated ($34,643 vs $64,001 p=0.000). The CLD group was older on average (68.35 vs 61.34 years old). CONCLUSIONS: Our data suggests that CLD may contribute to higher in-patient mortality, longer length of stay and higher total inpatient charges in patients diagnosed with CLD. We hope that these results highlight the importance of timely diagnosis and the need to focus on improving outcomes for this population of patients. CLINICAL IMPLICATIONS: The results from this study can lead to the continued research into factors that are contributing to the large discrepancy on in-hospital outcomes and assist clinicians in making important decisions in regards to patients presenting with pulmonary embolus who have concomitant CLD. DISCLOSURES: No relevant relationships by Russell Arellanes, source=Web Response No relevant relationships by Andrew Dang, source=Web Response No relevant relationships by Eugene Ismailov, source=Web Response No relevant relationships by Robert Stephens, source=Web Response