Temporal Trends and Practice Patterns Associated With Utilization of Catheter-Based Interventions for Pulmonary...

Area of Science:

• Cardiology
• Interventional Radiology
• Public Health

Background:

• Pulmonary embolism (PE) is a significant cause of morbidity and mortality.
• Catheter-based interventions (CBI) are increasingly used for acute PE treatment.
• Understanding trends in CBI utilization among older patients is crucial.

Purpose of the Study:

• To investigate national trends in CBI utilization for hospitalized PE patients.
• To examine practice patterns and demographic disparities in CBI use.
• To identify factors associated with CBI use and outcomes in older adults.

Main Methods:

• Analysis of Medicare fee-for-service beneficiaries hospitalized with PE (June 2018 - September 2023).
• Outcomes analysis included a subset with follow-up data (June 2018 - December 2021).
• Utilized logistic regression to identify predictors of CBI use and associated complications.

Main Results:

• Over 313,000 PE hospitalizations identified; 9.12% received CBI (catheter-directed thrombolysis or mechanical thrombectomy).
• CBI utilization rose from 5.92% in 2018 to 14.1% in 2023, driven by mechanical thrombectomy.
• CBI was more common in teaching hospitals and males, less in smaller hospitals and Black patients. Older age, Black race, and distressed communities correlated with higher complication rates.

Conclusions:

• CBI use for PE has increased but remains unevenly distributed.
• Significant disparities exist in access to advanced PE therapies and associated outcomes.
• Further research is needed to address inequities in CBI utilization and outcomes for PE management.