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Intensive care treatment in acute pulmonary embolism in Germany, 2016 to 2020: a nationwide inpatient database study

Karsten Keller1,2,3, Ingo Sagoschen1, Ioannis T Farmakis2

  • 1Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.

Research and Practice in Thrombosis and Haemostasis
|September 25, 2024
PubMed

Insights

Pulmonary embolism (PE) patients admitted to the intensive care unit (ICU) were younger and had more risk factors, leading to a higher fatality rate. ICU admission was independently associated with increased in-hospital mortality for PE patients.

Area of Science:

  • Pulmonary Medicine
  • Critical Care Medicine
  • Epidemiology

Background:

  • Pulmonary embolism (PE) is a serious condition where prompt intensive care unit (ICU) admission is crucial for critically ill patients.
  • Understanding the factors leading to ICU admission and patient profiles is vital for optimizing care.

Purpose of the Study:

  • To identify risk factors associated with ICU admission in pulmonary embolism (PE) patients.
  • To compare patient profiles, including risk factors and comorbidities, between PE patients admitted to the ICU and those treated on a general ward.

Main Methods:

  • Analysis of a nationwide inpatient sample from Germany (2016-2020).
  • Stratification of 484,859 hospitalized PE patients based on ICU admission.
  • Statistical analysis to identify independent risk factors for ICU admission and compare patient characteristics.

Main Results:

  • 19.0% of PE patients were admitted to the ICU.
  • ICU patients were younger and had a higher prevalence of cardiovascular risk factors and comorbidities.
  • ICU admission was independently associated with a 2.54-fold increased in-hospital case fatality rate.
  • Key predictors for ICU admission included hemodynamic instability, decompensation, arterial hypertension, diabetes, obesity, surgery, stroke, pregnancy, heart failure, atrial fibrillation/flutter, COPD, and renal failure.

Conclusions:

  • ICU admission for PE patients is linked to hemodynamic compromise, cardiovascular risk factors, stroke, pregnancy, and cardiopulmonary/renal comorbidities.
  • ICU admission significantly increases the risk of in-hospital mortality for PE patients.
  • Identifying these predictors can aid in timely ICU referral and management of severe PE cases.
Abstract

Keywords:
ICUhemodynamic instabilityintensive carepulmonary embolismvenous thromboembolism

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