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Hospitalizations for High-Risk Pulmonary Embolism.
Paul D Stein1, Fadi Matta1, Mary J Hughes1
1Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing.
The American Journal of Medicine
|November 27, 2020
Summary
The incidence of pulmonary embolism (PE) has risen, with high-risk PE cases increasing significantly. This suggests more potentially lethal PE cases are being diagnosed, not necessarily overdiagnosis.
Area of Science:
- Pulmonary Medicine
- Diagnostic Imaging
- Epidemiology
Background:
- The incidence of pulmonary embolism (PE) has been increasing.
- Widespread computed tomographic pulmonary angiography (CTPA) may contribute to overdiagnosis.
- This study investigates if the rise in PE incidence reflects overdiagnosis.
Purpose of the Study:
- To evaluate whether the increasing incidence of pulmonary embolism (PE) represents overdiagnosis.
- To analyze trends in PE diagnosis and high-risk PE cases.
- To assess the diagnostic accuracy and implications of rising PE rates.
Main Methods:
- Retrospective cohort study utilizing administrative data from the National (Nationwide) Inpatient Sample (NIS) from 1999-2014.
- International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes were used for patient identification and diagnosis.
- US population data from the Centers for Disease Control and Prevention (CDC) were used to calculate incidence rates.
Main Results:
- PE incidence rose from 65 to 137 per 100,000 population (P < .0001).
- High-risk PE incidence increased from 2.2 to 9.9 per 100,000 population (P < .0001).
- In-hospital mortality for high-risk PE patients was 52.2%.
Conclusions:
- The incidence of high-risk pulmonary embolism (PE) has increased in parallel with overall PE incidence.
- A growing proportion of patients with potentially lethal PE are being diagnosed.
- Findings suggest an increase in diagnosed severe PE cases, warranting further investigation into diagnostic practices.
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