Racial Disparities and Other Socioeconomic Predictors of Mortality in Acute Pulmonary Embolism Treatment from the National Inpatient Sample.

Autor:	Breuer JA; School of Medicine, University of California Irvine, Irvine, California. Electronic address: jbreuer@hs.uci.edu., Ahmed KH; School of Medicine, University of California Irvine, Irvine, California., Scherr R; School of Medicine, University of California Irvine, Irvine, California., Sing C; School of Medicine, University of California Irvine, Irvine, California., Daid M; College of Osteopathic Medicine, Touro University of Nevada, Henderson, Nevada., Nouizi F; Department of Radiological Sciences, University of California Irvine, Irvine, California., Huynh KN; Department of Radiological Sciences, University of California Irvine, Irvine, California., Sadigh G; Department of Radiological Sciences, University of California Irvine, Irvine, California., Chinchilla D; Department of Medicine, University of California, Irvine, Irvine, California., Abi-Jaoudeh N; Department of Radiological Sciences, University of California Irvine, Irvine, California.
Jazyk:	angličtina
Zdroj:	Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2024 Sep; Vol. 35 (9), pp. 1377-1387. Date of Electronic Publication: 2024 Mar 20.
DOI:	10.1016/j.jvir.2024.03.022
Abstrakt:	Purpose: To explore the significance of socioeconomic factors such as race and ethnicity as predictors of mortality in submassive and massive acute pulmonary embolism (PE). Materials and Methods: Hospitalizations of patients aged >18 years with acute, nonseptic PE from 2016 to 2019 were identified from the National Inpatient Sample and divided into interventional radiology (IR) (catheter-directed thrombolysis and thrombectomy) and non-IR (tissue plasminogen activator) treatments. Statistical analyses calculated significant odds ratios (ORs) via 95% confidence intervals (CIs). The primary outcome of interest was mortality rate. Comorbidities affecting mortality were examined secondarily. Results: Non-Hispanic (NH) Black, Hispanic, and Asian/Pacific Islander patients were significantly less likely to undergo an IR procedure for acute, nonseptic PE compared with White patients (NH Black, OR, 0.83 [95% CI, 0.76-0.90], P < .05; Hispanic, 0.78 [0.68-0.89], P = .06; Asian/Pacific Islander, 0.71 [0.51-0.98], P = .72); however, these differences were eliminated when propensity score matching was performed for age, biological sex, and primary insurance type or for primary insurance type alone. NH Black patients were significantly more likely to die than White patients, regardless of undergoing non-IR or IR treatment. Overall risk of death was 41% higher for NH Black patients than for White patients (relative risk, 1.41 [95% CI, 1.24-1.60]; P < .001). Conclusions: NH Black patients have a higher risk of mortality from acute, nonseptic PE than White patients. Independent of race, undergoing IR management for acute, nonseptic PEs was associated with a lower mortality rate. Matching for primary insurance type eliminates differences in mortality between races, suggesting that socioeconomic status may determine outcomes in acute PE. (Copyright © 2024. Published by Elsevier Inc.)
Databáze:	MEDLINE
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