Pulmonary vascular disease & thromboembolism
Trends in Discharge Rates for Acute Pulmonary Embolism in U.S. Emergency Departments
Main finding · ED discharge rateResult — go to the resultAdjusted relative risk 1.01 CI 0.89–1.14Authors' conclusion
In a representative nationwide sample, rates of discharge from the ED for acute PE appear to have remained constant between 2012 and 2020. Only one third of low-risk patients were discharged for outpatient management, and rates seem to have stabilized.
Study context
- Population
- Patients with ED visits for acute pulmonary embolism (PE) in US emergency departments (EDs) participating in the National Hospital Ambulatory Medical Care Survey, 2012–2020
- Participants
- 1,635,300 approximate weighted ED visits
- Exposure
- ED discharge rates for acute PE over time
- Outcome
- National trends in the proportion of ED discharges for acute PE
- Follow-up
- 2012–2020
Methodological detailsnationally representative survey (NHAMCS), Limitations: cross-sectional survey design; inability to adjudicate diagnoses
- Nationally representative survey (NHAMCS)
- Limitations: cross-sectional survey design; inability to adjudicate diagnoses
Main finding
ED discharge rate
Adjusted relative risk
1.01
CI 0.89–1.14
By group
Per year
adjusted RR 1.01 (CI 0.89–1.14)
Per year, as printed
As reported in the abstract
Observational data: associations, not effects.
Further findings
Percent
Low-risk by PESI class
35.9%(CI 23.9%–50.0%)
Low-risk by simplified PESI
33.1%(CI 21.6%–47.0%)
Low-risk by hemodynamic stability
34.8%(CI 23.3%–48.0%)
Baseline characteristics associated with ED discharge
- No baseline characteristics, including established risk stratification scores, predicted increased likelihood of ED discharge
- Teaching hospitals and private insurance more likely to receive oral anticoagulation at discharge
Original publication
Trends in Discharge Rates for Acute Pulmonary Embolism in U.S. Emergency Departments. Ann Intern Med. Published 30 January 2024. doi:10.
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