Chest
Volume 121, Issue 3, March 2002, Pages 802-805
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Clinical Investigations
Plumonary Embolism
Estimated Incidence of Acute Pulmonary Embolism in a Community/Teaching General Hospital

https://doi.org/10.1378/chest.121.3.802Get rights and content

Purpose

This study attempts to determine the incidence of established acute pulmonary embolism (PE) in a community/teaching general hospital.

Background

The reported incidence of objectively diagnosed acute PE among hospitalized adults in a large urban hospital or major university hospital ranges from 0.27 to 0.40%. Whether the incidence of PE in other categories of hospitals fits within this narrow range is unknown.

Methods

Patients with acute PE diagnosed by ventilation/perfusion lung scan, pulmonary angiography, compression ultrasound in a patient with suspected PE, autopsy, or (by coincidence) lung biopsy were identified among patients hospitalized during a 2-year period from 1998 to 2000. The incidence of PE was also determined according to age, sex, and race.

Results

Among adult patients (≥ 20 years old), the incidence of established acute PE was 95 of 34,567 patients (0.27%; 95% confidence interval [CI], 0.22 to 0.34%). No PE was diagnosed in patients < 20 years old. The incidence of PE in men was 36 of 13,722 patients (0.26%; 95% CI, 0.18 to 0.36%); in women, it was 59 of 20,845 patients (0.2%; 95% CI, 0.22 to 0.36%; not significant [NS]). The incidence in African-Americans adults was 10 of 4,344 patients (0.23%; 95% CI, 0.11 to 0.42%); in white adults, it was 84 of 28,615 patients (0.29%; 95% CI, 0.23 to 0.36%; NS).

Conclusion

The incidence of PE in a community/teaching general hospital was comparable to the incidence in a large urban-care center and in a major university hospital.

Section snippets

Materials and Methods

A computer search was made of discharge diagnoses of all patients hospitalized at St. Joseph Mercy-Oakland, Pontiac, MI, during a 2-year period from July 1, 1998 through June 30, 2000. St. Joseph Mercy-Oakland is a general hospital with a published sample census of 269 patients.6 It is an American College of Surgeons' designated teaching hospital and cancer center. It is a trauma center; it is not a burn center. There is no fixed policy for prophylaxis against deep venous thrombosis. Patients

Results

During the 2-year period of study, there were 44,136 patients admitted to the hospital, including newborns. The incidence of PE was 95 of 44,136 patients (0.22%; 95% CI, 0.17 to 0.26%). No patients < 20 years old had PE. Of adult patients (≥ 20 years old), the incidence of acute PE was 95 of 34,567 patients (0.27%; 95% CI, 0.22 to 0.34%).

The basis for the diagnosis of acute PE was pulmonary angiography in 14 patients, a positive contrast enhanced spiral CT in 1 patient, a high-probability

Discussion

The incidence of acute PE among adult patients in a community/teaching general hospital, 0.27%, was in the range reported in a large urban-care hospital and in a large university hospital, 0.27 to 0.40%.3, 4, 5

The criteria used for identification of patients with PE in the present investigation included the detection of deep venous thrombosis by compression ultrasound among patients with suspected PE and a nondiagnostic V˙/ Q˙ scan.10, 11, 12 This strategy of diagnosis of PE is now

ACKNOWLEDGMENT

The authors thank Prathyusha Savarapu, MMBS, Ibetsam Rafeea, MD, Meenakshi Sharma, MD, and Rebecca G. Estrellado for assistance in preparation of the data.

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