Ankur Girdhar1*, Junaid Bhatti A2 and Amita Singh1
1Division of Pulmonary, University of Florida College of Medicine, USA
2Department of Surgery, University of Toronto, Canada
Objective: Previous investigations on Acute Pulmonary Embolism (APE) have rarely made a comparison of those diagnosed in inpatient settings with those diagnosed in the outpatient settings. This study aimed to compare risk factors, symptoms and outcomes between APE cases on the basis of settings where they were diagnosed.
Methods: This is a single center retrospective review of all hospitalized patients who were diagnosed with APE over a 5 year period. We used the ICD codes to extract data on patients diagnosed with APE. Patients diagnosed with APE at the time of admission or within 48 hours of hospital admission were grouped as outpatient. Patients who were diagnosed with APE after 48 hours of hospital admission were grouped as inpatient.
Results: The sample included 82 APE cases diagnosed in inpatient settings and 95 APE cases diagnosed in the outpatient settings. Compared to APE cases diagnosed in the outpatient settings, cases diagnosed in the inpatient settings were more likely to be immobilized for 3 days or more (odds ratio [OR]=8.02, 95% confidence intervals [95% CI]=2.94-21.88), had central venous catheterization (OR=10.91, 95% CI=3.05-39.01), and have thrombocytosis (OR=5.23, 95% CI=1.19- 23.02). Hospital length of stay (LOS) following the diagnosis of APE in the inpatient APE cases was longer compared to diagnosis in outpatient settings. Adverse outcome including death or major bleeding after the diagnosis of APE was significantly higher in the inpatient group. Conclusions: These findings emphasize the need for vigilance in the management of APE diagnosed in two different settings, and warrant a review of decision-making approach to the diagnosis and treatment of APE in patients who develop it in the inpatient setting.
Acute pulmonary embolism; Inpatient; Outpatient; Outcomes
Girdhar A, Junaid Bhatti A, Singh A. Comparison of Acute Pulmonary Embolism Cases Diagnosed in the Inpatient Setting Versus Those in the Outpatient Setting. Clin Respirat Med. 2018; 1(2): 1007.