Correlates of in-hospital deaths among hospitalizations with pulmonary embolism: findings from the 2001-2008 National Hospital Discharge Survey

• Published in: PloS one 2012-07, Vol.7 (7), p.e34048-e34048
• Main Authors: Tsai, James, Grosse, Scott D, Grant, Althea M, Reyes, Nimia L, Hooper, W Craig, Atrash, Hani K
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biology; Birth defects; Blood diseases; Cancer; Child; Child, Preschool; Chronic illnesses; Codes; Comorbidity; Confidence intervals; Correlation analysis; Developmental disabilities; Diagnosis; Diagnostic systems; Disease control; Disease prevention; Editorials; Embolism; Embolisms; Emergency medical care; Epidemiology; Fatalities; Female; Fractures; Health aspects; Health Care Surveys; Hospital admission and discharge; Hospitalization; Hospitals; Humans; Infant; Male; Medical diagnosis; Medicine; Middle Aged; Morbidity; Mortality; Pneumonia; Primary care; Public health; Pulmonary arteries; Pulmonary embolism; Pulmonary Embolism - epidemiology; Pulmonary Embolism - mortality; Pulmonary embolisms; Quality of life; Regression analysis; Regression models; Risk factors; Statistical analysis; Subgroups; Systems design; Thromboembolism; Thrombosis; United States - epidemiology; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0034048

Deep vein thrombosis and pulmonary embolism (PE) are responsible for substantial mortality, morbidity, and impaired health-related quality of life. The aim of this study was to evaluate the correlates of in-hospital deaths among hospitalizations with a diagnosis of PE in the United States. By using data from the 2001-2008 National Hospital Discharge Survey, we assessed the correlates of in-hospital deaths among 14,721 hospitalizations with a diagnosis of PE and among subgroups stratified by age, sex, race, days of hospital stay, type of admission, cancer, pneumonia, and fractures. We produced adjusted rate ratios (aRR) and 95% confidence intervals using log-linear multivariate regression models. Regardless of the listing position of diagnostic codes, we observed an increased likelihood of in-hospital death in subgroups of hospitalizations with ages 50 years and older (aRR = 1.82-8.48), less than 7 days of hospital stay (aRR = 1.43-1.57), cancer (aRR = 2.10-2.28), pneumonia (aRR = 1.79-2.20), or fractures (aRR = 2.18) (except for first-listed PE), when compared to the reference groups with ages 1-49 years, 7 days or more of hospital stay, without cancer, pneumonia, or fractures while adjusting for covariates. In addition, we observed an increased likelihood of in-hospital death for first-listed PE in hospitalizations of women, when compared to those of men (aRR = 1.45). The results of this study provide support for identifying, developing, and implementing effective, evidence-based clinical assessment and management strategies to reduce PE-related morbidity and mortality among hospitalized PE patients who may have concurrent health conditions including cancer, pneumonia, and fractures.