Emergency department diagnosis of pulmonary embolism is associated with significantly reduced mortality: A linked data population study

George Jelinek, Sharyn Ingarfield, David Mountain, Nick Gibson, Ian Jacobs

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    13 Citations (Scopus)

    Abstract

    Objectives: We characterized patients admitted via ED with a principal hospital discharge diagnosis of pulmonary embolism (PE) and compared mortality of those diagnosed in the ED with those diagnosed after admission.Methods: Patients with a hospital discharge diagnosis ICD 10 I26 presenting to the ED in Perth, Western Australia between 1 July 2000 and 30 December 2006 had records from the Emergency Department Information System linked to the Western Australian Hospital Morbidity Data System and the death registry.Results: Of 2250 patients (mean age 60.4), 1227 (54.5%) were female. Of 1931 patients with an ED diagnosis recorded, 1207 (62.5%) were diagnosed with PE in ED. Of these, 383 (17.0%) had presented to an ED within 28 days previously, 142 (37.1%) with either chest pain or breathing problems, with 207 (54.0%) admitted but not receiving a principal hospital discharge diagnosis of PE. There were 127 (5.6%) in-hospital deaths. Controlling for age and comorbidity with logistic regression, patients diagnosed with PE in ED were less likely to die in hospital, within 7 and 30 days of ED arrival, than those diagnosed after admission (adjusted OR 0.31, 95% CI 0.20–0.47; adjusted OR 0.32, 95% CI 0.19–0.53; adjusted OR 0.30, 95% CI 0.20–0.44; respectively).Conclusion: Making the diagnosis of PE in ED was associated with a substantial survival advantage that persisted after hospital discharge.
    Original languageEnglish
    Pages (from-to)269-276
    JournalEmergency Medicine Australasia
    Volume21
    Issue number4
    DOIs
    Publication statusPublished - 2009

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