Aalam Ahmad, Bokhary Diyaa, Alsabban Awad, Bakhribah Ahmad
Department of Emergency Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Department of Internal Medicine, Taif University College of Medicine, Taif, Saudi Arabia.
Emerg Med Int. 2025 Jan 20;2025:6610196. doi: 10.1155/emmi/6610196. eCollection 2025.
Pulmonary embolism (PE) poses substantial morbidity and mortality risks, necessitating timely and accurate management in emergency departments (EDs). This study explores the trends in PE presentations to US EDs from 2006 to 2018 and assesses the impact of different factors on management and cost. This is a retrospective descriptive study conducted using the US Healthcare Cost and Utilization Project (HCUP) PE ED visits database. Data on ED visits, dispositions, and related costs were collected and analyzed. From 2006 to 2018 there were more than 2 million PE ED visits in the US. There was an increase in visits per 100,000 persons from 42.17 in 2006-2008 to 64.27 in 2016-2018 ( value < 0.001). The proportion of uninsured patients declined from 5.07% to 4.70%, and the percentage of Medicaid-insured patients increased. There was a decrease in the admission rates from 92.47% to 75.97% in 2016-2018 ( value < 0.001). The mean cost per admitted patient increased from $32,794 to $47,344 in 2016-2018 ( value < 0.001). From 2006 to 2018, PE ED visits in the US increased with a noticeable decrease in admission rates and length of stay, likely secondary to advancement in diagnostic and therapeutic modalities like computed tomography pulmonary angiography and novel oral anticoagulants. However, the observed rising healthcare costs pose challenges to sustainable management. Further research studies are needed to address cost-effective strategies.
肺栓塞(PE)会带来严重的发病和死亡风险,因此在急诊科(EDs)需要及时、准确的治疗。本研究探讨了2006年至2018年美国急诊科肺栓塞就诊情况的趋势,并评估了不同因素对治疗和成本的影响。这是一项使用美国医疗成本和利用项目(HCUP)肺栓塞急诊科就诊数据库进行的回顾性描述性研究。收集并分析了急诊科就诊、处置及相关成本的数据。2006年至2018年,美国急诊科有超过200万次肺栓塞就诊。每10万人的就诊次数从2006 - 2008年的42.17次增加到2016 - 2018年的64.27次(P值<0.001)。未参保患者的比例从5.07%降至4.70%,而医疗补助参保患者的比例有所增加。2016 - 2018年住院率从92.47%降至75.97%(P值<0.001)。2016 - 2018年每位住院患者的平均成本从32,794美元增加到47,344美元(P值<0.001)。2006年至2018年,美国急诊科肺栓塞就诊次数增加,住院率和住院时间显著下降,这可能是由于计算机断层扫描肺动脉造影和新型口服抗凝剂等诊断和治疗方式的进步。然而,观察到的医疗成本上升对可持续治疗构成挑战。需要进一步的研究来探讨具有成本效益的策略。