Hospital Costs of Acute Pulmonary Embolism

Fanikos, John; Rao, Amanda; Seger, Andrew C.; Piazza, Gregory; Goldhaber, Samuel Z.

doi:10.1016/s0735-1097(12)62120-2

Cited by 31 publications

(39 citation statements)

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“…Data are scarce regarding cost components associated with care of hospitalised patients with the primary diagnosis of PE. In a recent US study, the largest components of PE care expenses were nursing costs, followed by pharmacy and radiology costs [8]. Surprisingly, in our study, the greatest dispersion of values of cost was observed for pharmaceutical products in all SOI classes.…”

Section: Discussioncontrasting

confidence: 72%

“…Most studies focused on charges as an index of healthcare resource utilisation [3,4,[7][8][9]. However, charges may significantly differ from actual costs.…”

Section: Discussionmentioning

confidence: 99%

“…Most studies used reimbursement costs as an index of healthcare resource utilisation ( [7][8][9] and https://tct.fgov.be/webetct/ etct-web/). However, actual costs may be significantly different from charges.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of costs from the hospital perspective of primary pulmonary embolism

et al. 2015

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Section: Discussioncontrasting

confidence: 72%

“…Most studies focused on charges as an index of healthcare resource utilisation [3,4,[7][8][9]. However, charges may significantly differ from actual costs.…”

Section: Discussionmentioning

confidence: 99%

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Predictors of costs from the hospital perspective of primary pulmonary embolism

et al. 2015

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“…Another possibility that may explain the cost trend is that more procedures are performed or the cost of procedures has increased over time. In any case, several studies have shown that the costs per hospitalisation associated with pulmonary embolism events are substantial [23, [33][34][35].…”

Section: Pulmonary Vascular Diseases | J De Miguel-díez Et Almentioning

confidence: 99%

Trends in hospital admissions for pulmonary embolism in Spain from 2002 to 2011

et al. 2014

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“…Despite anticoagulant therapy, mortality risk increases after hospital discharge, mainly due to recurrent PE. A study in the USA found an in-hospital mortality rate of 4.2 % and that the 90-day mortality rate after hospital discharge increased to 13.8 % [13]. A study in Iceland found a 30-day mortality rate of 9.9 % [14].…”

mentioning

confidence: 99%

Perfusion SPECT in patients with suspected pulmonary embolism: how much sensitivity is needed to keep patients alive?

Schuemichen

2013

Eur J Nucl Med Mol Imaging

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Combined use of ventilation (V) and perfusion (P) scintigraphy for the diagnosis of acute and chronic thromboembolic pulmonary embolism (PE) has been well established for nearly 50 years, and is also anchored in the current European guidelines [1,2]. The intention in using this technique is to differentiate between local V/P mismatch associated with embolic disease and local V/P match related to obstructive airway disease. This functional approach to the diagnosis of PE is needed mostly in elderly patients, since the incidence of obstructive airway disease increases with age. With Ponly scintigraphy the rate of false-positive findings increases to an unacceptable 47 % even with SPECT/CT [3]. Despite well-documented advantages, V scintigraphy has not become popular in many European countries for various reasons: availability (Italy), expense, fear of radioactive contamination, and lack of quality control (Germany).In 2005, P-only scintigraphy was performed in 89 % of all lung examinations in Italy, in 72.4 % in Germany, in 44.1 % in Spain, in 21.3 % in the UK, and in only 12.4 % in France [4]. Proof or exclusion of PE was intended in most of these studies. Two years later, following the success of CT pulmonary angiography (CTPA), the number of V scintigraphies in Germany increased by 25 %, but lung examinations went down by 37 %. In Italy, morphological attributes (PISA-PED criteria) as a substitute for V scintigraphy have been added to reduce false-positive results from P-only planar scintigraphy. Single or multiple wedge-shaped P defects, with or without matching chest roentgenographic abnormalities, are reported as PE-positive. Wedge-shaped areas of overperfusion usually coexist. P defects other than wedgeshaped are PE-negative. With pulmonary angiography as reference, the P lung scan has been shown to have a sensitivity of 92 % and a specificity of 87 % in the diagnosis of PE [5]. Compared to CTPA and also V/P planar scintigraphy with PIOPED II interpretation together with chest radiography, the sensitivity of P-only planar scintigraphy with PISA-PED interpretation is somewhat below 90 %, but diagnostic accuracy is remarkably similar [6]. Applying V/P SPECT as reference, with interpretation criteria of the European guidelines, the sensitivity of P-only SPECT with PISA-PED interpretation criteria rose to an acceptable 90 %, and specificity to a fantastic 98 %. Segmental pneumonia was mentioned as a cause of false-positive findings, which could have been identified on a chest radiograph or more easily by SPECT/CT. These very promising results may be misinterpreted as an invitation to get rid of unpopular V scintigraphy.From our own experience it seems reasonable that the appearance of secondary perfusion defects in chronic obstructive airway disease (COPD) at the lobar and segmental level may be irregular and does not follow the lobar and segmental anatomy with a frequency that, if need be, is sufficient for diagnosis of PE. However, perfusion defects at the subsegmental level are mostly not distinguishable in ...

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Hospital Costs of Acute Pulmonary Embolism

Cited by 31 publications

References 0 publications

Predictors of costs from the hospital perspective of primary pulmonary embolism

Predictors of costs from the hospital perspective of primary pulmonary embolism

Trends in hospital admissions for pulmonary embolism in Spain from 2002 to 2011

Perfusion SPECT in patients with suspected pulmonary embolism: how much sensitivity is needed to keep patients alive?

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