PB1318 - Patient characteristics associated with all-cause mortality of incident hospitalized pulmonary embolism patients: a nationwide cohort study

Tuesday, July 12, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Presenting Author(s)

Qingui Chen, MD

Phd student
Leiden University Medical Center
Leiden, Zuid-Holland, Netherlands

Co-Author(s)

Nienke van Rein, PharmD PhD

Post doc, PhD PharmD
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
Leiden, Zuid-Holland, Netherlands
SC

Suzanne C. Cannegieter, MD PhD

Professor
Department of Clinical Epidemiology, Leiden University Medical Center
Leiden, Zuid-Holland, Netherlands

Background: The prognosis after a pulmonary embolism (PE) varies from no symptoms to death. However, large-scale studies on patient characteristics associated with a worse prognosis are rare.

Aims: To explore patient characteristics associated with all-cause mortality of incident hospitalized PE patients.

Methods: Incident PE patients (ICD-10 code: I26) admitted to hospitals in The Netherlands between 2013 and 2018 were identified using nationwide data from Statistics Netherlands. Age, sex, socioeconomic status, prior antithrombotic agents use, and comorbidities were studied as patient characteristics. All patients were followed from incident PE diagnosis for 1 year or until date of death. To study the association of patient characteristics with mortality, we estimated cumulative incidences and hazard ratios (HRs) of 30-day or 1-year all-cause mortality by Kaplan-Meier estimator and Cox regression respectively.

Results: 61,322 incident PE patients were included with a mean age of 64.8±15.6 years. The overall 30-day and 1-year cumulative incidence of all-cause mortality was 10.05% (95% confidence interval (CI) 9.82-10.29%) and 24.22% (95%CI 23.88-24.56%), respectively. For 30-day all-cause mortality, older age was a significant risk factor (HR=1.04 per 1-year increase, 95%CI 1.03-1.04), while sex was not. Immigration background, not married or in partnership, low household income, and prior use of antithrombotic agents (within 6 months before the incident PE) were associated with 30-day mortality. Amongst comorbidities, intracerebral hemorrhage, malignant tumor, abnormal liver function, heart failure, and stroke showed the strongest associations (i.e., HR>2). The association pattern for 1-year all-cause mortality was similar, where the association was strongest for cancer (HR=5.08, 95%CI 4.91-5.25). Detailed results are presented in the Tables.

Conclusion(s): This study showed that increasing age, an immigration background, being single, a low household income, prior use of antithrombotic agents and most comorbidities were associated with all cause-mortality after a PE. This information may help to predict prognosis of PE.