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. 2015 Mar 24;16(1):44.
doi: 10.1186/s12931-015-0203-9.

National trends in emergency room diagnosis of pulmonary embolism, 2001-2010: a cross-sectional study

Andrew J Schissler  1 , Anna Rozenshtein  2 , Neil W Schluger  3   4 , Andrew J Einstein  5   6   7
Affiliations

National trends in emergency room diagnosis of pulmonary embolism, 2001-2010: a cross-sectional study

Andrew J Schissler et al. Respir Res. .

Abstract

Background: Little is known about the United States diagnosis and burden of pulmonary embolism (PE) in the emergency department (ED), and their evolution over the past decade. We examined nationally representative data to evaluate factors associated with and trends in ED diagnosis of PE.

Methods: We conducted a cross-sectional study using National Hospital Ambulatory Medical Care Survey (NHAMCS) data from January 1, 2001 to December 31, 2010. We identified all ED patient visits where PE was diagnosed and corresponding demographic, hemodynamic, testing and disposition data. Analyses were performed using descriptive statistics and multivariable logistic regression.

Results: During the study period 988,000 weighted patient visits with diagnosis of PE were identified. Among patients with an ED visit, the likelihood of having a diagnosis of PE per year increased significantly from 2001 to 2010 (odds ratio [OR] 1.091, 95% confidence interval [CI] 1.034-1.152, P = 0.002 for trend) when adjusted for demographic and hospital information. In contrast, when further adjusted for the use of computed tomography (CT) among patients in the ED, the likelihood of having a diagnosis of PE per year did not change (OR 1.041, 95% CI 0.987-1.097, P = 0.14). Overall, 75.1% of patients seen with a diagnosis of PE were hemodynamically stable; 86% were admitted with an in-hospital death rate under 3%.

Conclusions: The proportion of ED visits with a diagnosis of PE increased significantly from 2001 to 2010 and this rise can be attributed in large part to the increased availability and use of CT. Most of these patients were admitted with low in-hospital mortality.

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Figures

Figure 1
Figure 1
Trends in ED visits with a diagnosis of PE over time. Shows trends in US population, ED visits with a diagnosis of PE and all other ED visits over time in two-year intervals.
See this image and copyright information in PMC

References

    1. Goldhaber SZ, Bounameaux H. Pulmonary embolism and deep vein thrombosis. Lancet. 2012;379(9828):1835–46. doi: 10.1016/S0140-6736(11)61904-1. - DOI - PubMed
    1. Agnelli G, Becattini C. Acute pulmonary embolism. N Engl J Med. 2010;363(3):266–74. doi: 10.1056/NEJMra0907731. - DOI - PubMed
    1. Mahan CE, Borrego ME, Woersching AL, Federici R, Downey R, Tiongson J, et al. Venous thromboembolism: annualised United States models for total, hospital-acquired and preventable costs utilising long-term attack rates. Thromb Haemost. 2012;108(2):291–302. doi: 10.1160/TH12-03-0162. - DOI - PubMed
    1. Barritt DW, Jordan SC. Anticoagulant drugs in the treatment of pulmonary embolism. A controlled trial. Lancet. 1960;1(7138):1309–12. doi: 10.1016/S0140-6736(60)92299-6. - DOI - PubMed
    1. Weiss CR, Scatarige JC, Diette GB, Haponik EF, Merriman B, Fishman EK. CT pulmonary angiography is the first-line imaging test for acute pulmonary embolism: a survey of US clinicians. Acad Radiol. 2006;13(4):434–46. doi: 10.1016/j.acra.2006.01.002. - DOI - PubMed

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