Article Impact Level: HIGH Data Quality: STRONG Summary of Clinical Cardiology, 46(7), 768–776. https://doi.org/10.1002/clc.24055 Dr. Alexander E. Sullivan et al.
Points
- Racial disparities in acute pulmonary embolism (PE) outcomes were studied in US healthcare, with Black and White patients as the focus.
- Data from 782 PE patients between January 2016 and June 2017 revealed that Black patients had higher BMI, were younger, and had a higher history of heart failure. White patients had higher rates of malignancy and recent surgery.
- Treatment disparities were observed: Black patients were more likely to receive systemic thrombolysis, while White patients had higher surgical embolectomy rates.
- In-hospital mortality rates were similar between the two racial groups, but Black patients had extended hospital stays and were more frequently prescribed warfarin.
- These findings highlight the need to address racial disparities in acute PE management to ensure equitable healthcare outcomes.
Summary
This research paper delves into the pervasive issue of racial disparities in healthcare, mainly focusing on patients with acute pulmonary embolism (PE) in the United States. The central hypothesis of this study postulated that Black and White patients admitted with acute PE would exhibit contrasting in-hospital outcomes. To scrutinize this hypothesis, comprehensive data analysis was conducted using medical records of PE patients spanning from January 1, 2016, to June 30, 2017, based on ICD-10 codes.
Among the 782 patients diagnosed with acute PE, the racial breakdown was 319 (40.8%) Black and 463 (59.2%) White. When examining demographic and clinical characteristics, Black patients exhibited a higher median BMI (30.3 vs. 29.3 kg/m2) and were notably younger (median age 61 vs. 67 years) than their White counterparts. Moreover, Black patients had a significantly higher prevalence of heart failure history (16.0% vs. 7.1%), whereas White patients displayed higher rates of malignancy (46.9% vs. 34.5%) and recent surgery (29.6% vs. 18.2%).
Regarding treatment approaches, Black patients were more likely to receive systemic thrombolysis (3.1% vs. 1.1%), while White patients had numerically higher rates of surgical embolectomy (0.3% vs. 1.1%). Although there was no substantial difference in inpatient mortality rates, Black patients had a more extended hospital stay (median 5.0 vs. 4.0 days) and were more likely to be prescribed warfarin (23.5% vs. 12.1%).
In conclusion, this study’s findings revealed that in-hospital mortality rates did not significantly differ between Black and White patients following acute PE. However, substantial racial disparities were evident in various facets of care, including hospital length of stay, medication prescriptions (warfarin), and treatment modalities (thrombolysis vs. surgical embolectomy). These findings underscore the imperative need for further exploration into the root causes of these disparities to ensure the delivery of equitable healthcare services and improved patient outcomes.
Link to the article: https://onlinelibrary.wiley.com/doi/10.1002/clc.24055
References Sullivan, A. E., Barbery, C. E., Holder, T., Green, C. L., Patel, M. R., Thomas, K. L., & Jones, W. S. (2023). Association of race and in‐hospital outcomes following acute pulmonary embolism: A retrospective cohort study. Clinical Cardiology, 46(7), 768–776. https://doi.org/10.1002/clc.24055
