In-Hospital Pulmonary Thromboembolism Development by Disease at Admission　- A Nationwide, Retrospective,...

Prevention of death from in-hospital pulmonary thromboembolism (PE) is crucial, but research exploring the risk factors for this event remains limited.

This retrospective analysis evaluated PE data among hospitalized patients, focusing on the diseases present on admission to hospital with the highest number of patients with in-hospital PE events, using the Medical Data Vision database (January 2017-December 2021). Endpoints included the incidence rate of in-hospital PE, patient characteristics, and PE prophylactic procedures. Overall, 4,684,659 patients (in-hospital PE cohort, n=5,007; non-PE cohort, n=4,679,952) were eligible: heart failure (n=208; n=87,160), femoral fracture (n=478; n=139,049), pneumonia (n=309; n=222,257), stroke (n=351; n=248,805), and cancer (n=934; n=764,413). The incidence rate of in-hospital PE in the overall population was 20.6/1,000 person-years: heart failure (34.6), femoral fracture (35.3), pneumonia (21.4), stroke (15.9), and cancer (25.6). History of venous thromboembolism (VTE) was a risk factor for in-hospital PE in >50% of patients in all subgroups. Prophylactic PE procedures were implemented in 33.8% of the overall population: femoral fracture (79.5%), cancer (49.7%), stroke (24.2%), heart failure (12.7%), and pneumonia (6.2%).

The incidence of in-hospital PE was not high overall but was higher in patients with a history of VTE and those with hospitalization due to heart failure or femoral fracture. Risk assessment for in-hospital PE, including medical history and diagnosis at admission, is preferred in hospitalized patients.