Background: Pulmonary embolism (PE) and atrial fibrillation (AF) may coexist. The association and impact of AF on PE have not been well studied. Methods: We queried the 2018 National Inpatient Sample (NIS) database to identify PE and AF hospitalizations using appropriate ICD-10 codes. PE with AF group was compared to PE without AF. Chi-square test [...]

Background: Multiple factors can lead to overuse of diagnostic imaging for venous thromboembolism (VTE). These include fear of missing a potentially fatal diagnosis, low predictive accuracy of clinical gestalt, prediction rules, and risk assessment models for VTE, and increased access to imaging. Diagnostic imaging for deep venous thrombosis (DVT) with doppler ultrasonography, or for pulmonary [...]

Background: International VTE management guidelines recommend outpatient management for appropriate patients with low-risk deep vein thrombosis (DVT) or pulmonary embolism (PE)[1-3]. Despite the evidence and recommendations, previous studies reported low prevalence of outpatient management, especially for PE[4, 5]. This analysis aimed to characterize trends in outpatient vs. inpatient management of VTE in the last 5 [...]

Background: Venous thromboembolism, in particular, pulmonary embolism (PE), is a significant contributor to morbidity and mortality associated with COVID-19. In comparison to influenza, COVID-19 leads to a more pronounced hypercoagulable state secondary to endotheliopathy and hyperinflammatory state which results in the formation of venous and arterial thrombosis. Based on prior literature, patients with COVID-19 have [...]

Background: The Choosing Wisely campaign discourages CT imaging in low-risk patients with suspected pulmonary embolism (PE) (e.g., low clinical probability and negative d-dimer). Few studies have investigated patient, provider, or operational characteristics associated with overuse of CT imaging. One possible approach to this research question is to examine variability in diagnostic yield (i.e., the percentage [...]

Background: The In-hospital Mortality for Pulmonary embolism using Claims daTa (IMPACT) rule has been validated in a number of commercial and all-payer claims databases; classifying pulmonary embolism (PE) patients into low- and higher-risk in-hospital all-cause mortality categories with a sensitivity of 87% and specificity of 47%. We sought to directly compare the accuracy of IMPACT [...]

Background: Venous thromboembolism (VTE) in hospitalized medically ill patients is a leading preventable cause of morbidity and mortality in the United States. About half of VTE events occur following discontinuation of standard-duration in-hospital prophylaxis and hospital discharge. The APEX study evaluated Betrixaban for in-hospital to home VTE prophylaxis and is the first FDA approved anticoagulant [...]

Background: Venous thromboembolism (VTE) in hospitalized medically ill patients is a leading preventable cause of morbidity and mortality in the United States. About half of VTE events occur following discontinuation of standard-duration in-hospital prophylaxis and hospital discharge. The APEX study evaluated Betrixaban for in-hospital to home VTE prophylaxis and is the first FDA approved anticoagulant [...]

Background: Prognostic risk scores allow clinicians to rapidly identify patients with acute pulmonary embolism (PE) at a low risk for mortality and morbidity. Current guidelines recommend that these patients be considered for outpatient treatment. Despite this, most patients with low-risk PE are still hospitalized for monitoring and initiation of anticoagulation. Interventions to improve provider awareness [...]

Background: D-dimer is one of the most commonly used tests because of its high sensitivity, but a high false positive rate prevents healthcare providers from efficiently diagnosing pulmonary embolism (PE). This leads to many patients unnecessarily undergoing CT pulmonary angiography (CTPA) scans in the emergency department (ED). This study sought to determine if there is [...]