Ibrahim Said A, Stone Roslyn A, Obrosky D Scott, Sartorius Jennifer, Fine Michael J, Aujesky Drahomir
Veterans Administration Center for Health Equity Research and Promotion, Pittsburgh Healthcare System, Pittsburgh, Pa 15240, USA.
Am J Public Health. 2006 Dec;96(12):2161-4. doi: 10.2105/AJPH.2005.078618. Epub 2006 Oct 31.
Previous studies reported a higher incidence of in-hospital mortality for Black patients who had pulmonary embolism than for White patients. We used a large statewide database to compare 30-day mortality (defined as death within 30 days from the date of latest hospital admission) for Black and White patients who were hospitalized because of pulmonary embolism.
The study cohort consisted of 15531 discharged patients who had been treated for pulmonary embolism at 186 Pennsylvania hospitals between January 2000 and November 2002. We used random-effects logistic regression to model 30-day mortality for Black and White patients, and adjusted for patient demographic and clinical characteristics.
The unadjusted 30-day mortality rates were 9.0% for White patients, 10.3% for Blacks, and 10.9% for patients of other or unknown race. When adjusted for severity of disease using a validated clinical prognostic model for pulmonary embolism, Black patients had 30% higher odds of 30-day mortality compared with White patients at the same site (adjusted odds ratio = 1.3; 95% confidence interval, 1.1,1.6). Neither insurance status nor hospital volume was a significant predictor of 30-day mortality.
Black patients who had pulmonary embolism had significantly higher odds of 30-day mortality compared with White patients.
先前的研究报告称，患有肺栓塞的黑人患者院内死亡率高于白人患者。我们使用了一个大型的全州数据库，比较因肺栓塞住院的黑人和白人患者的30天死亡率（定义为自最近一次住院日期起30天内死亡）。
研究队列包括2000年1月至2002年11月期间在宾夕法尼亚州186家医院接受肺栓塞治疗的15531名出院患者。我们使用随机效应逻辑回归对黑人和白人患者的30天死亡率进行建模，并对患者的人口统计学和临床特征进行了调整。
未调整的30天死亡率，白人患者为9.0%，黑人患者为10.3%，其他或种族不明的患者为10.9%。当使用经过验证的肺栓塞临床预后模型对疾病严重程度进行调整后，与同一地点的白人患者相比，黑人患者30天死亡率的几率高30%（调整后的优势比 = 1.3；95%置信区间，1.1,1.6）。保险状况和医院规模均不是30天死亡率的显著预测因素。
与白人患者相比，患有肺栓塞的黑人患者30天死亡率的几率显著更高。
