Trends in case fatality rate in pulmonary embolism according to stability and treatment

Stein, Paul D.; Matta, Fadi; Al‐Rifai, Ahmad; Rahman, Akhil

doi:10.1016/j.thromres.2012.07.011

Cited by 54 publications

(36 citation statements)

References 29 publications

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“…However, a recent observational study conducted in the USA revealed a decrease in case fatality rate attributable to pulmonary embolism from 1998-2008, which is largely due to a reduction of the case fatality rate in stable patients. There was no reduction of case fatality rate with thrombolytic therapy, although unstable patients who received a combination of vena cava filter with thrombolytic therapy had a relatively low case fatality rate [39]. Therefore, outcomes such as length of hospital stay may have been influenced by other covariates that were different to those we studied.…”

Section: Pulmonary Vascular Diseases | J De Miguel-díez Et Almentioning

confidence: 63%

Trends in hospital admissions for pulmonary embolism in Spain from 2002 to 2011

et al. 2014

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Section: Pulmonary Vascular Diseases | J De Miguel-díez Et Almentioning

confidence: 63%

Trends in hospital admissions for pulmonary embolism in Spain from 2002 to 2011

et al. 2014

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“…Concurrent bleeding, unstable condition, sepsis or septic shock, infection, anemia, trauma, and pregnancy were all recorded using ICD‐9 diagnosis codes 13, 20. Patients receiving thrombolytic therapy, embolectomy procedures, or major surgery were identified using a combination of procedural codes 21. Patients who died during the hospitalization during which the VCF was placed were also noted.…”

Section: Methodsmentioning

confidence: 99%

Vena Cava Filter Retrieval Rates and Factors Associated With Retrieval in a Large US Cohort

Brown

Raissi

Han

et al. 2017

JAHA

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BackgroundRetrieval of vena cava filters (VCFs) is important for safety as complications increase with longer dwell times. This study assessed VCF retrieval rates and factors associated with retrieval in a national cohort.Methods and Results VCFs were identified by procedural codes from an administrative claims database. Patients were identified who had a VCF placement during a hospitalization from a national commercial administrative claims database. Indications for VCF placement were identified as pulmonary embolism with or without deep vein thrombosis, deep vein thrombosis only, or prophylactic. Patient demographic and clinical characteristics were included in proportional hazard regression models to find associations with early (90‐day) and 1‐year VCF retrieval. Initiation of anticoagulation and the correlation between time‐to‐retrieval and time‐to‐initiation of anticoagulation were observed. Of 54 766 patients receiving a VCF, 36.9% had pulmonary embolism, 43.9% had deep vein thrombosis only, and 19.2% had no apparent venous thromboembolism present. Over the 1 year of follow‐up, the cumulative incidence of VCF retrieval was 18.4%. Retrieval increased over time from a low of 14.0% in 2010 up to ≈24% in 2014. In adjusted time‐to‐event models, increasing age, differing regions, and some comorbidities were associated with poorer retrieval rates. Initiation of anticoagulation was poorly correlated with retrieval, with anticoagulation preceding retrieval by a median of 51 days while those without retrieval had a median of 278 days of exposure to anticoagulation.Conclusions VCF retrieval increased over the study period but remained suboptimal and was weakly correlated with anticoagulation initiation.

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“…For example, the in-hospital allcause case fatality rate for all patients with PE decreased from 11.8% in 1999 to 7.4% in 2008 in a study representative of hospitals from across the United States, and this change was driven by a reduction in case-fatality rates among stable patients. 24 This figure suggests that the implementation of the vascular unit allowed us to achieve a case-fatality rate from PE in the 2007-2010 period comparable to the one observed in the United States in 1999, likely by the identification and treatment of stable patients who could otherwise have been missed. In contrast, the implementation of a national program for the detection and treatment of PE in China may have contributed to a decrease in the PE case-fatality rate, the magnitude of which was comparable to ours (from 25.1% in 1997 to 8.7% in 2008).…”

Section: Limitationsmentioning

confidence: 83%