Prevalence and outcomes of pulmonary embolism with sickle cell disease: Analysis of the Nationwide Inpatient Sample, 2016–2020

Abstract

Introduction The outcomes of pulmonary embolism (PE) in sickle cell disease (SCD) are poorly established in the literature. This study examined the prevalence and outcomes of patients with PE and SCD. Methods The National Inpatient Sample was used to identify patients' data with a diagnosis of PE and SCD in the United States from 2016 to 2020 using the International Classification of Disease, 10th Revision codes. Logistic regression was used to compare outcomes between those with and without SCD. Results Of the 405 020 patients with PE, 1504 (0.4%) had SCD, and 403 516 (99.6%) did not have SCD. The prevalence of PE with SCD was stable. Patients in the SCD group were more likely to be female (59.5% vs. 50.6%; p < .0001), Black (91.7% vs. 54.4%; p < .0001), with a lower rate of comorbidities. The SCD group had higher in‐hospital mortality (odds ratio [OR] = 1.41, 95% confidence interval [CI]:1.08–1.84; p = .012) but lower catheter‐directed thrombolysis (OR = 0.23, 95% CI: 0.08–0.64; p = .005), mechanical thrombectomy (OR = 0.59, 95% CI: 0.41–0.64; p < .0029), and inferior vena cava filter placement (OR = 0.47, 95% CI: 0.33–0.66; p < .001). Conclusion In‐hospital mortality remains high in PE with SCD. A proactive approach, including maintaining a high index of suspicion for PE, is needed to reduce in‐hospital mortality.

Chronic kidney disease and outcomes in hospitalized sickle cell disease patients: A National Inpatient Sample analysis

“…First, there is a possibility of coding errors and missing diagnostic codes in administrative databases like the NIS, as we used ICD‐10 codes to identify various diagnoses and procedure. However, NIS is a robust database that has been used in previous studies of SCD hospitalizations 35,36 . ICD‐10 codes have been shown to possess sufficient accuracy for identification of adult patients with SCD for observational studies 37,38 .…”