Gender Disparities in Outcomes and Resource Utilization for Acute Pulmonary Embolism Hospitalizations in the United States

Current data regarding gender disparities in outcomes after acute pulmonary embolism (PE) are limited and controversial. We sought to assess the gender-specific rates and trends in treatment, outcomes, and complications after acute PE. We used the 2003 to 2011 Nationwide Inpatient Sample database fo...

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Bibliographic Details
Published in:The American journal of cardiology 2015-10, Vol.116 (8), p.1270-1276
Main Authors: Agarwal, Shikhar, MD, MPH, Clark, Donald, MD, Sud, Karan, MD, Jaber, Wael A., MD, Cho, Leslie, MD, Menon, Venu, MD
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Age
Aged
Cardiovascular
Cost estimates
Databases, Factual
Datasets
Embolisms
Female
Gender
Health facilities
Health Resources - utilization
Health Status Disparities
Hospitalization
Hospitalization - statistics & numerical data
Hospitals
Humans
Male
Medicare
Middle Aged
Morbidity
Mortality
Nursing
Pulmonary Embolism - complications
Pulmonary Embolism - mortality
Pulmonary Embolism - therapy
Retrospective Studies
Sex Factors
Socioeconomic factors
Software
Thromboembolism
Treatment Outcome
Trends
United States - epidemiology
Variables
Womens health
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Summary:Current data regarding gender disparities in outcomes after acute pulmonary embolism (PE) are limited and controversial. We sought to assess the gender-specific rates and trends in treatment, outcomes, and complications after acute PE. We used the 2003 to 2011 Nationwide Inpatient Sample database for this analysis. All hospital admissions with a principal diagnosis of acute PE were identified using the International Classification of Diseases, Ninth Edition , codes. Inhospital mortality and discharge to nursing facility were co-primary outcomes of our study. Secondary outcomes included shock, transfusion of blood products, utilization of thrombolysis, inferior vena cava filter placement, and cost of hospitalization. Over a 9-year period, a total of 276,484 discharges with acute PE were identified. Compared with men, there was significantly higher inhospital mortality in women admitted with acute PE (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.03 to 1.15). In addition, there was a significantly higher need for discharge to nursing facility among women compared with men (OR 1.30, 95% CI 1.27 to 1.34). Besides this, women experienced a higher need for transfusion (OR 1.38, 95% CI 1.33 to 1.44) and occurrence of shock (OR 1.10, 95% CI 1.01 to 1.18) during hospitalization. Furthermore, there was a significantly lower utilization of vena cava filters (OR 0.86, 95% CI 0.84 to 0.89) in women compared with men. Among patients in shock who were eligible for thrombolysis (age
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2015.07.048