Abstract 4363400: Readmission and Outcomes in Patients with Pulmonary Embolism requiring either Catheter Directed Thrombolysis or Mechanical Thrombectomy.

Abstract

Introduction: Pulmonary embolism (PE) is a critical condition requiring prompt and effective treatment to reduce morbidity and mortality. Catheter-directed thrombolysis (CDT) and mechanical thrombectomy (MT) are two key reperfusion strategies employed to manage PE. Despite their widespread use, there is limited comparative data on their impact on 30-day readmission rates (30-dr) and other clinical outcomes. Aim: The aim of this study was to compare 30-dr in patients with PE treated with CDT vs MT. Methods: Using the Nationwide Readmission Database, we conducted a retrospective analysis of patients with pulmonary embolism who underwent reperfusion therapy by either CDT or MT between 2017 and 2021. The primary outcome was 30-dr, while secondary outcomes included inpatient mortality, length of stay, and total hospital charge (THC). Multivariate and descriptive bivariate analyses were conducted, with p-values <0.05 considered statistically significant. Results: A total of 62,097 patients met the inclusion criteria, with 52.4% males and 47.6% females, and a mean age of 60.9 ± 13.8 years. The mean age was slightly lower in the CDT group (60.7 ± 13.7 years) compared to the MT group (61.5 ± 13.9 years, p < 0.01). Patients treated with CDT had significantly lower odds of 30-day readmission (OR 0.70, 95% CI 0.61-0.81, p < 0.01) and a lower mortality rate (HR 0.75, 95% CI 0.65-0.86, p < 0.01) compared to those treated with MT. In addition, the CDT group experienced a lower LOS (5 vs. 7 days) and higher THC ($28,082 vs. $39,242, p < 0.01). Conclusion: Our study showed that acute PE patients treated with CDT had lower 30-dr and mortality rates compared with MT.