Time to Mechanical Thrombectomy Does Not Impact In-Hospital Outcomes for Acute Submassive Pulmonary Embolism: A Retrospective Cohort Study

Sunday, March 5, 2023

3:27 PM – 3:36 PM

Location: Phoenix Convention Center, 226ABC

Presenting Author(s)

Zain M. Khazi, MD

Radiology resident
University of Missouri- Columbia

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

AB

Ambarish Bhat, MD

Assistant Professor of Radiology
University of Missouri- Columbia

Disclosure(s):

Zain M. Khazi, MD: No financial relationships to disclose

Purpose:

To determine if time to mechanical thrombectomy (MT) for submassive pulmonary embolism (PE) impacts length of hospital stay, 30-day readmission rate, and 30-day mortality rate.

Materials and Methods:

Retrospective review of all patients that underwent MT for acute submassive PE from November 2019 to July 2022 were analyzed. Pediatric patients (age < 18) and massive PE were excluded from the study. Patient characteristics, comorbidities, vitals, laboratory values including cardiac biomarkers, hospital course, readmission rates, and 30-day mortality rates were recorded. Additionally, time from diagnosis of submassive PE on CT scan to MT was also recorded and stratified as MT within 12 hours and MT after 12 hours of diagnosis. Pearson’s Chi-squared and student’s t-tests were utilized to compare the two cohorts. Additionally, multiple logistic regression analyses were also performed to identify risk factors for 30-day readmission and mortality rates with statistical significance defined as p< 0.05.

Results:

There were 69 patients (58.9 years, 56.5% female) with acute submassive PE that underwent MT with a technical success of 98.6% (n=68) included in the study. Of these, 39% (n=27) of patients underwent MT within 12 hours of diagnosis. There was no significant difference in length of hospital stay between the cohorts (8±14.1 vs 6.9±6 days, p = 0.7). Time to MT within 12 hours was not an independent risk factor for 30-day readmission (OR: 6.69, 95% CI: 0.03-99, p=0.9) and 30-day mortality (OR: 0.33, 95% CI: 0.01-7.89, p=0.9). However, increasing age was an independent risk factor for 30-day mortality (OR: 1.2, 95% CI: 1.03-1.48, p=.04).

Conclusion:

MT within 12 hours from diagnosis of acute submassive PE does not significantly impact length of hospital stay, 30-day readmission rate, and 30-day mortality rate when compared to MT after 12 hours after diagnosis. However, older age was an independent risk factor for 30-day mortality.