Racial differences in 30-day mortality for pulmonary embolism

Area of Science:

• Cardiovascular Medicine
• Health Disparities Research
• Epidemiology

Background:

• Previous studies indicate higher in-hospital mortality for Black patients with pulmonary embolism (PE) compared to White patients.
• A significant knowledge gap exists regarding racial disparities in 30-day mortality following PE hospitalization.

Purpose of the Study:

• To compare 30-day mortality rates between Black and White patients hospitalized for pulmonary embolism (PE).
• To investigate potential contributing factors to observed disparities in PE outcomes.

Main Methods:

• A retrospective analysis of 15,531 patients discharged with PE from 186 Pennsylvania hospitals (2000-2002).
• Random-effects logistic regression was employed to model 30-day mortality, adjusting for demographic and clinical factors.
• A validated clinical prognostic model was used to account for disease severity.

Main Results:

• Unadjusted 30-day mortality rates were 9.0% for White patients and 10.3% for Black patients.
• After adjusting for disease severity, Black patients exhibited 30% higher odds of 30-day mortality compared to White patients (aOR=1.3; 95% CI, 1.1-1.6).
• Insurance status and hospital volume did not significantly predict 30-day mortality.

Conclusions:

• Black patients with pulmonary embolism (PE) face significantly higher odds of 30-day mortality compared to White patients.
• These findings highlight persistent racial disparities in PE outcomes, necessitating further investigation into underlying causes and targeted interventions.