Association between Hispanic or Latino ethnicity and pulmonary embolism severity, management, and in-hospital outcomes

Snyder, Daniel J
Zilinyi, Robert S
V Madhavan, Mahesh
Alsaloum, Marissa
Saleem, Danial
Buyske, John J
Healy, Emma W
McGredy, Maxine J
Da Silva, Bernardo T
Rosenzweig, Erika B
Takeda, Koji
Brodie, Daniel
Agerstrand, Cara
Eisenberger, Andrew
Kirtane, Ajay J
Parikh, Sahil A
Sethi, Sanjum S

¹Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, NY, USA
²Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, NY, USA
³Department of Pediatrics, Division of Pediatric Cardiology, Columbia University Irving Medical Center, Morgan Stanley Children’s Hospital, NY, USA
⁴Department of Surgery, Division of Cardiothoracic Surgery, Columbia University Irving Medical Center, NY, USA
⁵Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University Irving Medical Center, NY, USA
⁶Department of Medicine, Division of Hematology and Oncology, Columbia University Irving Medical Center, NY, USA

Daniel Snyder, Department of Medicine, New York Presbyterian, Columbia University Irving Medical Center, 808 Columbus Ave Apt 16G, NY 10025, USA. Email: [email protected]; @DanSnyder01

Vascular Medicine 28(3):p 222-232, June 2023. | DOI: 10.1177/1358863X231157441

Background:

Hispanic and Latino patients are under-represented in existing healthcare disparities research in pulmonary embolism (PE). The goal of this study was to determine if differences in PE severity, treatment modality, or in-hospital outcomes exist for Hispanic or Latino patients with PE.

Methods:

All PE cases from 2013 to 2019 at a single institution were reviewed. Clinical characteristics, imaging findings, intervention types, and in-hospital and 30-day outcomes were collected. Two cohorts were created based on patients’ self-reported ethnicity. Outcomes were compared using univariate and multivariate analysis.

Results:

A total of 1265 patients were identified with confirmed PE; 474 (37%) identified as Hispanic or Latino. Hispanic or Latino patients presented with high-risk PE significantly less often (19% vs 25%, p = 0.03). On univariate analysis, Hispanic or Latino patients had lower rates of PE-specific intervention (15% vs 19%, p = 0.03) and similar rates of inpatient mortality (6.8% vs 7.5%, p = 0.64). On ordinal regression analysis, Hispanic or Latino ethnicity was associated with lower PE severity (OR 0.69, 95% CI 0.54–0.89, p = 0.003). In subgroup analyses of intermediate and high-risk PEs, ethnicity was not a significant predictor of receipt of PE-specific intervention or in-hospital mortality.

Conclusions:

At this institution, Hispanic or Latino patients were less likely to present with high-risk PE but had similar rates of inpatient mortality. Future research is needed to identify if disparities in in-hospital care are driving perceived differences in PE severity and what addressable systematic factors are driving higher-than-expected in-hospital mortality for Hispanic or Latino patients.