Disparities in the Outcomes of Acute Pulmonary Embolism in Hospitalized Patients with Hematologic Malignancy and Solid Tumor Evidence from the National Inpatient Sample 2016-2018

• Published in: International Heart Journal Vol. 64; no. 3; pp. 432 - 441
• Main Authors: Hou, Jingjing, Qiu, Zhongmin, Yu, Li, Wen, Siwan, Zheng, Ling
• Format: Journal Article
• Language: English
• Published: Tokyo International Heart Journal Association 31.05.2023; Japan Science and Technology Agency
• Subjects: Cancer; Diagnosis; Embolism; Healthcare Cost and Utilization Project (HCUP); Hospitalization; In-hospital mortality; Length of stay (LOS); Malignancy; Patients; Population studies; Population-based; Pulmonary embolisms; Solid tumors; Tumors
• ISSN: 1349-2365; 1349-3299
• DOI: 10.1536/ihj.22-704

This study aimed to compare the clinical burden and healthcare utilization outcomes of hematologic versus solid malignancies in patients hospitalized with acute pulmonary embolism (PE). This population-based, retrospective study extracted and analyzed the discharge data from the 2016-2018 US National Inpatient Sample (NIS) of hospitalized patients with a primary diagnosis of acute PE and a subsequent diagnosis of hematologic malignancies or solid tumors. Prolonged length-of-stay (LOS) was defined as ≥75th percentile LOS of the study cohort. Unfavorable discharge was defined as discharged to nursing home or long-term facility. Univariate and multivariate regression analyses were conducted to determine associations between cancer type, presence of unstable PE, and in-hospital outcomes in acute PE patients. Patients with acute PE with solid tumors had higher rates of in-hospital deaths and unfavorable discharge than those with hematologic malignancies (6.4% versus 3.2%, P < 0.001; 14.0% versus 11.2%, P = 0.01, respectively). Acute PE patients with hematologic malignancies had a lower risk of in-hospital death (aOR: 0.43, 95% CI: 0.31-0.60), unfavorable discharge (aOR: 0.76, 95% CI: 0.63-0.92), and prolonged LOS (aOR: 0.83, 95% CI: 0.71-0.98) than those with solid tumors. Stratified analysis showed that male patients aged <60 years with hematologic malignancies had a lower risk of prolonged LOS (aOR: 0.70, 95% CI: 0.52-0.94; aOR: 0.85, 95% CI: 0.68-1.05) and unfavorable discharge (aOR: 0.40, 95% CI: 0.22-0.71; aOR: 0.65, 95% CI: 0.50-0.85) than those with solid tumors. In the comparison of the outcomes of acute PE with hematologic malignancies and solid tumors, patients with hematologic malignancy had a lower risk of in-hospital deaths, prolonged LOS, and unfavorable discharge than those with solid tumors.