Effects of Thrombolytic Therapy in Low-Risk Patients With Pulmonary Embolism
Section snippets
Methods
This was a retrospective cohort study based on administrative data from the National Inpatient Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality, January 2016 through December 2017.2 The National Inpatient Sample in 2016 and 2017 was a sample of discharge records from all United States non-Federal, short-term, general, and other specialty hospitals participating in the Healthcare Cost and Utilization Project.2 Weighted estimates of the number of
Results
In 2016 and 2017, 343,545 patients were hospitalized with a primary diagnosis of low-risk PE (Figure 1). None underwent pulmonary embolectomy.
Mortality in low-risk patients with catheter-directed thrombolysis was somewhat higher than with anticoagulants (Table 3). Patients treated with intravenous thrombolytic therapy showed the highest mortality.
Matched low-risk patients showed results that were comparable to results with unmatched patients (Table 3). Mortality was lowest in patients treated
Discussion
The vast majority of low-risk patients with acute PE were treated with anticoagulants. Neither catheter-directed thrombolysis nor intravenous thrombolytic therapy resulted in lower mortality than anticoagulants alone. IVC filters did not reduce mortality in patients treated with anticoagulants alone. These observations are consistent with the recommendation that low-risk patients with PE should be treated with anticoagulants alone.1 Systematic review did not identify any randomized controlled
Disclosures
The authors have no conflicts of interest to disclose.
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Cited by (0)
Funding: None.