Recent Trends in Clinical Outcomes and Resource Utilization for Pulmonary Embolism in the United States Findings From the Nationwide Inpatient Sample
Recent Trends in Clinical Outcomes and Resource Utilization for Pulmonary Embolism in the United States Findings From the Nationwide Inpatient Sample
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DOI：
10.1378/chest.08-2258
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发表时间：
2009-10-01
期刊：
影响因子：
9.6
通讯作者：
Anderson, Frederick A.
中科院分区：
文献类型：
--
作者：
Park, Brian;Messina, Louis;Anderson, Frederick A.
背景：肺栓塞（PE）被认为是住院患者最常见的可预防的死亡原因。本研究的目的是确定最近的临床结果和资源利用的趋势，为住院患者的临床公认的急性PE.Methods发作：原发性或继发性PE谁已出院，从美国急性护理医院的患者被确定为在1998年至2005年的8年期间，从全国住院患者样本。评估的主要临床结局包括住院死亡率和住院时间。为了评估PE治疗的资源利用情况，对这些入院的平均医院费用进行评估，标准化为2005年美元，并调整以反映美国消费者价格指数。结果：1998年至2005年，出院的原发性或继发性PE患者人数从126，546人增加到229，637人;这些病人的住院病死率从12.3%下降到8.2%（P < 0.001）;住院时间从9.4天减少到8.6天（p < 0.001）;医院总收费由25，293元增至43，740元（p < 0.001）。在1998年至2005年期间，观察到因临床确认的PE住院患者的结局有显著改善，包括死亡率和住院时间的减少。在此期间，医院护理费用增加。（CHEST 2009; 136：983-990）
Background: Pulmonary embolism (PE) has been cited as the most common preventable cause of death in hospitalized patients. The objectives of this study were to determine recent trends in clinical outcomes and resource utilization for hospitalized patients with a clinically recognized episode of acute PE.Methods: Patients with primary or secondary PE who had been discharged from US acute care hospitals were identified from the Nationwide Inpatient Sample during the 8-year period between 1998 and 2005. The major clinical outcomes assessed included hospital mortality and length of hospitalization. To assess resource utilization for the treatment of PE, average hospital charges for these admissions were assessed, normalized to 2005 US dollars, and adjusted to reflect the US consumer price index.Results: Between 1998 and 2005, the number of patients with primary or secondary PE on discharge from the hospital increased from 126,546 to 229,637; hospital case fatality rates for these patients decreased from 12.3 to 8.2% (p < 0.001); length of hospital stay decreased from 9.4 days to 8.6 days (p < 0.001); and total hospital charges increased from $25,293 to $43,740 (p < 0.001).Conclusions: Between 1998 and 2005, significant improvements were observed in outcomes for patients hospitalized for clinically recognized PE, including decreases in mortality and length of hospital stay. Charges for this hospital care increased during this time period. (CHEST 2009; 136:983-990)