Skip Nav Destination Show 901. Health Services and Outcomes Research – Non-Malignant Conditions: Poster II| December 6, 2014 Ranjan Pathak, MD, 1Reading Health System, West Reading, PA Search for other works by this author on: Smith Giri, MD, 2University of Tennessee Health Science Center, Memphis, TN Search for other works by this author on: Madan Raj Aryal, MD, 1Reading Health System, West Reading, PA Search for other works by this author on: Paras Karmacharya, MD, 1Reading Health System, West Reading, PA Search for other works by this author on: Anthony A Donato, MDMHPE Anthony A Donato, MDMHPE * 1Reading Health System, West Reading, PA Search for other works by this author on:
Blood (2014) 124 (21): 3514.
AbstractIntroduction Saddle pulmonary embolism (PE), defined as thrombi at the bifurcation of pulmonary artery, occurs in about 2-5% of all PE cases. Due to relative rarity of this condition, studies aimed at describing the clinical attributes and outcomes have been limited by small sample size. Although clot burden was once believed to be important prognostically, recent data has challenged this assumption. Methods We used the Nationwide Inpatient Sample to identify all hospitalizations related to acute pulmonary embolism in the United States from the year 2009 to 2011. Nationwide Inpatient Sample is the largest all-payer publicly available inpatient care database in the US. It contains data from five to eight million hospital stays from about 1,000 hospitals across the country and approximates a 20% sample of all US hospitals. Using the appropriate International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes, the study cohort was divided into saddle and non-saddle groups. Baseline demographic and hospital characteristics, comorbidities, in-hospital mortality and complications were compared between the two groups. Data analysis was done using STATA, version 13.0 (College Station, TX). Results A total of 861,762 acute PE related hospitalizations were identified during the study period. Saddle PE was coded in 1472 (0.16%) hospitalizations. A significantly greater proportion of saddle PE cases were seen among males (p =0.01), obese (p<0.001), dyslipidemic (p<0.001) and diabetic patients (p<0.001). Although the in-hospital mortality rate was similar in the two groups (3.62% versus 3.19%, p=0.73), rates of cardiac arrest, cardiogenic shock, respiratory failure and thrombolysis were significantly higher in saddle PE. Conclusion Saddle PE carries similar prognosis compared to patients without this finding. Whether thrombolytics are necessary in hemodynamically stable patients is a matter for further study. Table 1. Univariate analysis of baseline characteristics, Saddle PE vs Non-saddle PE
AKI=Acute Kidney Injury; CAD=Coronary Artery Disease; CHF=Congestive Heart Failure; CKD=Chronic Kidney Disease; PE=Pulmonary Embolism; PVD=Peripheral Vascular Disease Table 2. Mean hospital charge, LOS and In-hospital mortality, Saddle PE vs Non-saddle PE
LOS=Length of Stay; PE=Pulmonary Embolism Disclosures No relevant conflicts of interest to declare. Author notes* Asterisk with author names denotes non-ASH members. © 2014 by The American Society of Hematology 2014 Thank you for submitting a comment on this article. Your comment will be reviewed and published at the journal's discretion. Please check for further notifications by email. Comment not saved. Please try again. How serious is a saddle pulmonary embolism?Saddle PE is a severe and life threatening condition that requires immediate medical attention. Without treatment, the condition can result in sudden death.
How common is a saddle pulmonary embolism?Massive saddle pulmonary embolism is rare, carrying a risk among individuals diagnosed with PE of 2.6%. There are well-known risk factors for development of PE, including venous stasis, obesity, trauma, advanced age, confirmed DVT, and hypercoagulable states.
What percentage of pulmonary embolisms are fatal?TABLE 1. What are the odds of surviving a massive pulmonary embolism?For clinical purposes, massive PE is defined as pulmonary embolism with either hemodynamic collapse or an occlusion of the pulmonary artery that exceeds 50% of its cross-sectional area. The overall mortality rate associated with massive PE remains at approximately 30%.
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What is the survival rate of a saddle pulmonary embolism
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