Faculty Collaboration Database

Healthcare Resource Utilization and Outcomes in Intermediate-Risk Pulmonary Embolism in the United States. Am J Cardiol 2025 Dec 15;257:183-190

Date

10/07/2025

Pubmed ID

41052696

DOI

10.1016/j.amjcard.2025.09.050

Scopus ID

2-s2.0-105020743627 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

Patients with intermediate-risk pulmonary embolism (PE) often experience extended hospitalizations and varied outcomes depending on the treatment modality. This study compares outcomes and healthcare resource utilization among patients treated with anticoagulation (AC), catheter-directed thrombolysis (CDL), other mechanical thrombectomy (MT), or computer-assisted vacuum thrombectomy (CAVT) in the U.S. Adult inpatients with intermediate-risk PE discharged between 07/01/2020 and 09/30/2023 were retrospectively identified from the Vizient Clinical Data Base. ICD-10 codes identified treatment modalities. Propensity score matching (PSM) equated groups 1:1 using demographics, payer and hospital type. Outcomes included length of stay (LOS), postprocedure LOS (PPLOS), postprocedure intensive care unit days (PPICU), in-hospital mortality, composite complications, discharge status, and readmission rates. PSM matched 515 patients across groups. Baseline data were similar. CAVT had shorter LOS (4.6 ± 3.23d) than AC (6.2 ± 3.72d, p < 0.0001), CDL (7.1 ± 4.42d, p < 0.0001), and MT (7.0 ± 4.62d, p < 0.0001). CAVT had shorter PPLOS (3.8 ± 3.16d) than CDL (6.1 ± 4.33d, p < 0.0001) and MT (6.2 ± 4.52d, p < 0.0001). CAVT had fewer and shorter PPICU stays than CDL (44.3% vs 82.7%, p < 0.0001; 0.7 ± 1.3d vs 1.6 ± 1.5d, p < 0.0001). CAVT showed lower composite complications than MT (1.2% vs 4.1%, p = 0.0034), and lower incidence of acute kidney injury development during hospitalization than MT (1.9% vs 4.9%, p = 0.0099) and CDL (1.9% vs 4.5%, p = 0.0214). In-hospital mortality, 30-day all-cause and PE-related readmissions were similar. CAVT had a higher rate of discharge to home (69%) than AC (55.5%, p < 0.0001), CDL (56.3%, p < 0.0001) and MT (52.6%, p < 0.0001). In conclusion, CAVT for intermediate-risk PE may shorten LOS, PPLOS, reduce complications, and improve discharge outcomes without increasing mortality compared to other treatment modalities.

Author List

Patel PJ, Dohad SY, Moriarty JM, Rosovsky R, Channick R, Weinberg I

Author

Parag J. Patel MD, MS Vice Chair, Professor in the Radiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Anticoagulants
Female
Health Resources
Hospital Mortality
Humans
Length of Stay
Male
Middle Aged
Patient Acceptance of Health Care
Propensity Score
Pulmonary Embolism
Retrospective Studies
Thrombectomy
Thrombolytic Therapy
United States