Acute Pulmonary Embolism During Pregnancy and Puerperium: National Trends and In-Hospital Outcomes
Por:
Elgendy, IY, Gad, MM, Mansoor, H, Mahmoud, AN, Elbadawi, A, Saad, A, Saad, M, Elkaryoni, A, Secemsky, EA, Mamas, MA, Monreal, M, Weinberg, I and Pepine, CJ
Publicada:
1 ago 2021
Ahead of Print:
1 ago 2021
Resumen:
Objective: To investigate the trend and outcomes of acute pulmonary embolism (PE) during pregnancy and puerperium using a large national database. Patients and Methods: The National Inpatient Sample was queried to identify pregnancy-related hospitalizations in the United States from January 1, 2007, through September 30, 2015. Temporal trends in the rates of acute PE and in-hospital mortality rates were extracted. Results: Among 37,524,314 hospitalizations, 6,333 patients (0.02%) had acute PE. The prevalence of comorbidities and risk factors such as hypertension, obesity, and smoking increased, but rates of acute PE did not change significantly (18.01 in 2007 vs 19.36 in 2015, per 100,000 hospitalizations, Ptrends=.21). Advanced therapies were used in a small number of women (systemic thrombolysis: 2.4%, surgical pulmonary embolectomy: 0.5%, and inferior vena cava filter in 8.3%). Rates of inhospital mortality were almost 200-fold higher among those who had acute PE (29.3 vs 0.13, per 1000 pregnancy-related, P<.001). The rate of in-hospital mortality did not change among women with acute PE (2.6% in 2007 vs 2.5% in 2015, Ptrends=.74). Conclusion: In this contemporary analysis of pregnancy-related hospitalizations, acute PE was uncommon, but rates have not decreased over the past decade. Acute PE during pregnancy and puerperium was associated with high maternal mortality, and the rates of in-hospital mortality have not improved. Future studies to improve prevention and management of acute PE during pregnancy and puerperium are warranted. (c) 2021 Mayo Foundation for Medical Education and Research center dot Mayo Clin Proc. 2021;96(8):2102-2113
Filiaciones:
Elgendy, IY:
Weill Cornell Med Qatar, Div Cardiol, Doha, Qatar
Gad, MM:
Cleveland Clin Fdn, Dept Med, 9500 Euclid Ave, Cleveland, OH 44195 USA
Mansoor, H:
Hamad Bin Khalifa Univ, Coll Hlth & Life Sci, Doha, Qatar
Mahmoud, AN:
Case Western Reserve Univ, Sch Med, Div Cardiol, Cleveland, OH USA
Harrington Heart & Vasc Inst, Cleveland, OH USA
Elbadawi, A:
Univ Texas Med Branch, Dept Cardiol, Galveston, TX 77555 USA
Saad, A:
Cleveland Clin Fdn, Dept Med, 9500 Euclid Ave, Cleveland, OH 44195 USA
Saad, M:
Brown Univ, Div Cardiol, Warren Alpert Sch Med, Providence, RI 02912 USA
Elkaryoni, A:
Loyola Univ Med Ctr, Div Cardiovasc Dis, Loyola Stritch Sch Med, Maywood, IL 60153 USA
Secemsky, EA:
Beth Israel Deaconess Med Ctr, Dept Med, Smith Ctr Outcomes Res Cardiol, Boston, MA 02215 USA
Beth Israel Deaconess Med Ctr, Dept Med, Div Cardiol, Boston, MA 02215 USA
Mamas, MA:
Keele Univ, Keele Cardiovasc Res Grp, Stoke On Trent, Staffs, England
Royal Stoke Univ Hosp, Stoke On Trent, Staffs, England
:
Hosp Badalona Germans Trias & Pujol, Dept Internal Med, Barcelona, Spain
Weinberg, I:
Massachusetts Gen Hosp, Div Cardiol, Boston, MA 02114 USA
Pepine, CJ:
Univ Florida, Div Cardiovasc Med, Gainesville, FL USA
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