Pulmonary vascular disease & thromboembolismCohort study
Trends in thrombolytic treatment and outcomes of acute pulmonary embolism in Germany
- Retrospective cohort study
- nationwide inpatient cohort
Authors' conclusion
In the nationwide inpatient cohort, thrombolytic therapy was associated with reduced in-hospital mortality rates in PE patients with shock, and also in those who underwent CPR.
Study context
- Population
- Patients hospitalised with acute pulmonary embolism (PE) in Germany, 2005–2015
- Participants
- 885,806 patients
- Exposure
- Systemic thrombolysis vs no thrombolysis
- Outcome
- Trends in use of systemic thrombolysis and in-hospital outcome
Main finding
As reported in the abstract
Trends 2005 to 2015
- PE incidence, overall
- 99/100 000 population/year
- PE incidence 2005 → 2015
- 85/100 000 → 109/100 000; β 0.32 (0.26-0.38), P < 0.001
- In-hospital case fatality 2005 → 2015
- 20.4% → 13.9%; β −0.51 (−0.52 to −0.49), P < 0.001
- Systemic thrombolysis use 2005 → 2015
- 3.1% → 4.4%; β 0.28 (0.25-0.31), P < 0.001
- Thrombolysis in haemodynamically unstable patients
- 23.1%
Observational data: associations, not effects.
Further findings
| Outcome | OR (CI) | P value | |
|---|---|---|---|
| In-hospital mortality, haemodynamically unstable patients (subgroups) — Thrombolysis vs No thrombolysis · shock without CPR or mechanical ventilation · independent of age, sex and comorbidities | 0.42 (0.37–0.48) | P < 0.001 | |
| In-hospital mortality, haemodynamically unstable patients (subgroups) — Thrombolysis vs No thrombolysis · underwent CPR · independent of age, sex and comorbidities | 0.92 (0.87–0.97) | P = 0.002 | |
| 0.20.5125Odds ratio (log scale) |
Original publication
Trends in thrombolytic treatment and outcomes of acute pulmonary embolism in Germany. Eur Heart J. Published 18 May 2019. doi:10.1093/eurheartj/ehz236
Summarised from the published abstract; every number is checked against it