Racial disparities in outcomes between caucasian and african american patients undergoing percutaneous pulmonary artery thrombectomy following pulmonary embolism

SESSION TITLE: Proceduralist Round Table SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/10/2023 12:00 pm - 12:45 pm PURPOSE: Recent studies have shown that African Americans are twice as likely to experience hospitalization for pulmonary embolism (PE) compared to Caucasians. Moreover, they are less likely to receive intervention for PE and more vulnerable to in-hospital deaths. Data pertaining to the differences based on outcomes of Percutaneous Pulmonary artery thrombectomy remains poorly understood. METHODS: We analyzed inpatient records via the 2016-2020 National Inpatient Sample (NIS) and included adults diagnosed with PE undergoing Percutaneous Pulmonary Artery Thrombectomy. A propensity-matched analysis was conducted to adjust for patient characteristics, comorbidities, and hospital demographics. Differences in outcomes and complications following Percutaneous Pulmonary Artery Thrombectomy were calculated. RESULTS: Between 2016 and 2020, an estimated 1,808,189 patients of ages 18 and older reported a PE diagnosis in the US. It included 1267514(67.9%) Caucasians and 338,170 (18.1% African Americans). Among them, 10,705 Caucasians (0.8%) and 3,200(0.9%) African Americans underwent Percutaneous Pulmonary Artery Thrombectomy. The African American patients were younger compared to the Caucasian cohort (mean age 56.69 vs. 63.46 years). After careful matching, a higher risk of requiring Extracorporeal membrane oxygenation (ECMO) (aOR 2.351, 95% CI 1.038-5.323, p=0.040) was noted among African Americans compared to Caucasians. Meanwhile, African Americans had lower odds of vascular complications ( aOR 0.856, 95% CI 0.455-1.609, p=0.629). No racial differences were seen for the use of mechanical ventilation (aOR 1.153, 95% CI 0.853-1.558, p=0.355), post-procedural bleeding (aOR 1.074, 95% CI 0.729-1.580, p=0.719), septicemia (aOR 1.071, 95% CI 0.707-1.622, p-0.746), acute kidney injury (AKI) (aOR 1.281, 95%CI 0.997-1.647, p=0.053), and cardiogenic shock (aOR 0.925, 95% CI 0.645-1.326, p=0.671). Finally, African Americans and Caucasians expressed no disparities in mortality rates (aOR 0.963, 95% CI 0.672-1.382, 95% CI 0.839). CONCLUSIONS: African Americans undergoing Percutaneous Pulmonary Artery Thrombectomy were younger and showed higher risks of needing ECMO but were less likely to report vascular complications. The two groups did not report disparities in mechanical ventilation use, septicemia, post-procedural bleeding, AKI, cardiogenic shock, or death. CLINICAL IMPLICATIONS: Some disparities in outcomes exist between African Americans and Caucasians undergoing Percutaneous Pulmonary Artery Thrombectomy in the United States. Further studies may help improve the care and outcomes. DISCLOSURES: No relevant relationships by Shruti Aggarwal No relevant relationships by Balkiranjit Kaur Dhillon No relevant relationships by Gulshan Kumar No relevant relationships by Madho Mal No relevant relationships by Indu Meena No relevant relationships by Prince Kwabla Pekyi-Boateng No relevant relationships by Saran Preet No relevant relationships by Kamleshun Ramphul No relevant relationships by Yogeshwareee Ramphul No relevant relationships by Abhimanyu Ravalani No relevant relationships by Hemamalini Sakthivel No relevant relationships by Sailaja Sanikommu No relevant relationships by Shaheen Sombans No relevant relationships by Renuka Verma