Pulmonary embolism: diagnosis, incidence and implications

Area of Science:

• Medical research
• Clinical epidemiology

Background:

• Pulmonary embolism (PE) is a significant cause of morbidity and mortality.
• Accurate prevalence and outcome data are essential for effective healthcare management.

Purpose of the Study:

• To determine the prevalence of pulmonary embolism (PE) at an academic tertiary care center.
• To identify diagnostic methods used for PE.
• To characterize patient outcomes following PE diagnosis.

Main Methods:

• Retrospective analysis of multiple data sources: Medical Information System, Pathology, Radiology, Nuclear Medicine, and Pharmacy records.
• Verification of positive PE cases through medical records.
• Development of a comprehensive list of all positive PE cases.

Main Results:

• A total of 320 patients developed pulmonary embolism (PE) during the study period.
• 121 patients died before discharge, resulting in a mortality rate of 1 per 1000 cases.
• Prevalence was 3.5 cases per 1000 admissions.
• Utilizing multiple data sources prevented significant misclassification and errors in rate estimation.
• Definitive diagnosis and treatment with a Greenfield filter correlated with improved early survival.

Conclusions:

• Accurate estimation of pulmonary embolism (PE) prevalence and outcomes requires integrating data from multiple sources.
• Reliance on single data sources, such as ICD-9 coding, can lead to substantial underestimation of PE cases and fatalities.
• Timely and definitive diagnosis, coupled with appropriate treatment strategies like Greenfield filter placement, can improve early survival rates in PE patients.