THE BURDEN OF PULMONARY EMBOLISM ON ETHNIC MINORITIES IN THE UNITED STATES: ANALYSIS OF THE NATIONWIDE INPATIENT SAMPLE DATABASE FROM 2015-2018

Abstract

TOPIC: Pulmonary Vascular Disease TYPE: Original Investigations PURPOSE: Defining national prevalence and trends of pulmonary embolism (PE) may help in evaluating the role of preventive measures and management strategies to minimize PE related mortality. This study was conducted to determine the age- and gender-adjusted national trends in PE-related hospitalizations in the U.S. using the largest nationally representative database. METHODS: We performed a cross-sectional study of the National Inpatient Sample database for all adult patients (≥ 18 years old) with PE as the principal diagnosis from October 1, 2015 to December 31, 2018. We analyzed the age- and gender-adjusted longitudinal trends in hospital admissions, in-hospital mortality, hospital charges, and hospital length of stay. RESULTS: Between 2015 to 2018, PE-related hospitalizations and in-hospital mortality increased. There was a significant increase in admissions of Afro-American and Hispanic patients (p=0.007, p=0.009, respectively). Hospitalizations increased in the uninsured but decreased in private payers (p=0.005, p=0.008, respectively). The number of patients with PE managed at teaching tertiary hospitals significantly increased (p<0.001). There was a significant decrease in proportion of co-morbid condition of diabetes among PE patients, whereas that of coronary artery disease (CAD), chronic kidney disease (CKD), and cerebrovascular disease (CVD) have increased from 2015-2018 (p<0.01). Moreover, hospital charges of PE patients were significantly increased (p<0.001). CONCLUSIONS: Analyses of temporal changes in PE showed stable hospitalization rates and hospital mortality in patients with pulmonary embolism. There was a significant increase in PE incidence in African-American and Hispanic population, with significant comorbidities, and no insurance coverage, with an increment in hospital charges. CLINICAL IMPLICATIONS: The observed increase in PE incidence in ethnic minorities with significant comorbidities and no insurance coverage raises concerns with respect to decreased access to health care being responsible for an increased risk of PE in these groups, and the resulting observed increase in hospital costs. DISCLOSURES: No relevant relationships by Jeeyune Bahk, source=Web Response No relevant relationships by Kam Sing Ho, source=Web Response No relevant relationships by David Steiger, source=Web Response