Clinical research studyHospital Costs of Acute Pulmonary Embolism
Section snippets
Materials and Methods
We enrolled consecutive hospitalized patients with pulmonary embolism at Brigham and Women's Hospital during the period from September 2003 to May 2010. By using our hospital medical records computer system, we identified patients using diagnostic-related group codes 175 (pulmonary embolism with major complication/comorbidity) and 176 (pulmonary embolism without major complication/comorbidity). Patients were included if there was a clinical diagnosis of pulmonary embolism or a diagnosis
Results
Overall, we identified 991 hospitalized patients with pulmonary embolism as the primary diagnosis. Baseline characteristics and comorbidities are shown in Table 1. The median age was 61 years, with 194 patients (19.6%) aged more than 75 years. There were more women (568, 57.3%) than men (423, 42.7%). The median length of hospital stay was 3 days (interquartile range, 2-5 days). Approximately half of our patients had active cancer (450, 45.4%), approximately one third were obese (315, 31.8%),
Discussion
Pulmonary embolism continues to have a high case fatality rate of 4.2% in-hospital and 13.8% at 90 days after hospital discharge. The average cost to treat each patient with pulmonary embolism was $8763. Nursing costs, followed by pharmacy and radiology, comprised the greatest component of the expense. In addition, we found an increasing trend in the prevalence of pulmonary embolism from 2004 to 2008, followed by a decline in 2009. Others have reported a steady increase in the number of
Conclusions
Our study indicates that pulmonary embolism continues to impose a high case fatality rate and a heavy economic burden. Future studies should investigate whether risk stratification and focused prevention efforts and treatment strategies to reduce length of hospital stay or to transition when appropriate to entirely outpatient management will reduce costs.
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Cited by (0)
Funding: This study was supported in part by Eisai, Inc.
Conflict of Interest: Dr Goldhaber receives research funds from Eisai, Inc, EKOS Corporation, and Sanofi-Aventis and is a consultant for Baxter, Boehringer Ingelheim, Bristol-Myers Squibb, Eisai, Inc, Merck, Portola, Pfizer, and Sanofi-Aventis. Dr Piazza is supported by a Research Career Development Award (K12 HL083786) from the National Heart, Lung, and Blood Institute. All other authors have no conflicts of interest associated with the work presented in this manuscript.
Authorship: All authors had access to the data and played a role in writing this manuscript.