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Clinical outcomes and echocardiographic characteristics between African American and Caucasian patients with acute pulmonary embolism.
Cires-Drouet, Rafael S; Sama, Jacob; Han, Paul; Jones, Kevin; Haase, Daniel; Miller, Taylor; Toursavadkohi, Shahab; Nagarsheth, Khanjan; Alston, Lateaqua; Smedley, Angela; Shanholtz, Carl; Mayorga-Carlin, Minerva; Sorkin, John D; Hong, Susie N; Ramani, Gautam; Griffith, Bartley; Lal, Brajesh K; Taylor, Bradley.
Affiliation
  • Cires-Drouet RS; Department of Surgery, University of Maryland, Baltimore, MD, USA.
  • Sama J; Department of Medicine, 12264University of Maryland School of Medicine, Baltimore, MD, USA.
  • Han P; Department of Medicine, 12264University of Maryland School of Medicine, Baltimore, MD, USA.
  • Jones K; The R. Adams Cowley Shock Trauma Center, Program in Trauma, 12264University of Maryland School of Medicine, Baltimore, MD, USA.
  • Haase D; The R. Adams Cowley Shock Trauma Center, Program in Trauma, 12264University of Maryland School of Medicine, Baltimore, MD, USA.
  • Miller T; Department of Medicine, 12264University of Maryland School of Medicine, Baltimore, MD, USA.
  • Toursavadkohi S; Department of Surgery, University of Maryland, Baltimore, MD, USA.
  • Nagarsheth K; Department of Surgery, University of Maryland, Baltimore, MD, USA.
  • Alston L; Department of Surgery, University of Maryland, Baltimore, MD, USA.
  • Smedley A; Department of Emergency Medicine, 12264University of Maryland School of Medicine, Baltimore, MD, USA.
  • Shanholtz C; Department of Medicine, 12264University of Maryland School of Medicine, Baltimore, MD, USA.
  • Mayorga-Carlin M; Department of Surgery, University of Maryland, Baltimore, MD, USA.
  • Sorkin JD; Department of Medicine, 12264University of Maryland School of Medicine, Baltimore, MD, USA.
  • Hong SN; Baltimore VA Geriatrics Research, Education, and Clinical Center, 20029Baltimore Veterans Affairs Medical Center, Baltimore, MD, USA.
  • Ramani G; Department of Medicine, 12264University of Maryland School of Medicine, Baltimore, MD, USA.
  • Griffith B; Department of Medicine, 12264University of Maryland School of Medicine, Baltimore, MD, USA.
  • Lal BK; Department of Surgery, University of Maryland, Baltimore, MD, USA.
  • Taylor B; Department of Surgery, University of Maryland, Baltimore, MD, USA.
Phlebology ; 37(9): 678-685, 2022 Oct.
Article in En | MEDLINE | ID: mdl-36114157
ABSTRACT

BACKGROUND:

Despite socioeconomic disparities, no association between clinical presentation and poor outcomes explains a higher mortality in African Americans with pulmonary embolism (PE). The objective is to identify the co-morbidities and echocardiographic characteristics associated with increased mortality in African American patients.

METHODS:

This is a cross-sectional study of Caucasian or African American patients with PE diagnosed between October 2015 and December 2017 at University of Maryland Medical Center. The outcomes were in-hospital death, length of stay, and bleeding.

RESULTS:

There were 303 African Americans and 343 Caucasians. Caucasians were older (p = 0.007), males (p = 0.01) with history of coronary artery revascularization (CABG (p = 0.001), coronary stents (p = 0.001)), trauma (p = 0.007), and/or recent surgeries (p = 0.0001). African Americans exhibited higher rates of diabetes (p = 0.01), chronic kidney disease (p = 0.0005), and smoking (p = 0.04). Severity of PE was similar between groups and there was no difference in clot burden size. African Americans had more right ventricular strain on Computer Tomography (p = 0.001) and echocardiogram (p = 0.004); also, underfilled left ventricles (p = 0.02) and higher right ventricular systolic pressures (p = 0.001). There was no difference in hospital mortality (7.1% vs. 7.9%, p = 0.71), length of stay (13.1 ± 16.7 vs 12.8 ± 14.9, p = 0.80) and bleeding (9.0% vs.8.3%. p = 0.72). Mortality was higher in African Americans who received advanced therapies (3.8% vs. 18.8%, p = 0.02). The risk of death increased with age (OR 1.04; 95%CI 1.020-1.073) and with advanced therapies (OR 2.43; 95%CI 1.029-5.769).

CONCLUSIONS:

Differences in co-morbidities, radiologic findings, and echocardiographic characteristics that may contribute to higher mortality in African American patients, specifically those receiving advanced therapies.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pulmonary Embolism / Black or African American Type of study: Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limits: Humans / Male Language: En Journal: Phlebology Journal subject: ANGIOLOGIA Year: 2022 Document type: Article Affiliation country: United States
Fulltext
Add to My VHL
Print
XML
PubMed Links
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pulmonary Embolism / Black or African American Type of study: Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limits: Humans / Male Language: En Journal: Phlebology Journal subject: ANGIOLOGIA Year: 2022 Document type: Article Affiliation country: United States