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Introduction: Currently, there is limited data on the optimal door-to-treatment time for acute pulmonary embolism (PE). Purpose: To determine the relationship between early vs late systemic thrombolytics (ST) on morbidity, and health care resource utilization in patients admitted to the hospital in the United States with acute PE. Method: A retrospective study was conducted using the AHRQ-HCUP National Inpatient Sample for the year 2014. Adults (≥ 18 years) with a principal diagnosis of acute PE and a procedural of systemic thrombolysis were identified using ICD-9 codes as described in the literature. The primary outcome was in-hospital mortality. Secondary outcomes were length of hospital stay (LOS), total hospitalization costs, and 30-day readmission rates. Propensity score (PS) using the next neighbor method without replacement with 1:1 matching was utilized to adjust for confounders. Results: In total, 156,293 hospital admissions with a primary diagnosis of acute PE, 2.6% had systemic thrombolysis within 24 hours of admission. In-hospital morality is similar between early and late ST (p=0.97). However, 30-day readmission rate was significantly lower for early ST compared to late ST (7.05 vs 19.5%, p Conclusion: Early use of ST was associated with a lower 30-day readmission rate, higher LOS, and higher total hospital cost. |
