ABSTRACT
Background: Percutaneous mechanical thrombectomy is an increasingly utilized treatment modality for acute pulmonary embolism (PE), improving pulmonary flow with embolus/thrombus modification. We aimed to investigated national trends and outcomes in patients with acute pulmonary embolism with and without cor pulmonale undergoing mechanical thrombectomy. Method(s): We utilized the National Inpatient Sample (NIS) Database 2016-2020 to identify the cohort with principal diagnosis of acute pulmonary embolism, with or without cor pulmonale using ICD-10 codes. Patients who had COVID-19 infection during hospital stay were excluded from the 2020 database. Primary outcome analysis included adjusted inpatient mortality rate utilizing predictive margins, during each calendar year stratified by sex, age, race, and median household income (MHOI). Result(s): There were a total of 389,527 hospitalizations (367,205 without cor pulmonale;22,322 with cor pulmonale) with a principal diagnosis of acute PE from 2016-2020. Out of these hospitalizations, 3,168 (0.81%) underwent mechanical thrombectomy during hospital stay. Ratio of mechanical thrombectomy amongst all PEs increased significantly throughout the years (0.39% in 2016 vs 1.68% in 2020, p trend <0.001). There was a significant decline in mortality of patients without cor pulmonale undergoing mechanical thrombectomy (12.72% in 2016 vs. 8.30% in 2020, p-trend <0.001), however this trend was not observed in patients with cor pulmonale (12.11% in 2016 vs. 8.87% in 2020, p-trend = 0.45). Conclusion(s): Our findings suggest that, throughout the years of 2016-2020, there was a trend suggesting an increase in ratio of mechanical thrombectomy amongst patients admitted with pulmonary embolism and decrease in inpatient mortality in patients without cor pulmonale undergoing mechanical thrombectomy. [Formula presented]Copyright © 2023