Racial disparities in patients with pulmonary embolism treated with systemic thrombolysis vs ultrasound-assisted, catheter-directed thrombolysis

SESSION TITLE: Pulmonary Vascular Disease Posters 8 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/11/2023 12:00 pm - 12:45 pm PURPOSE: Pulmonary Embolism (PE) is an important cause of morbidity and mortality. There are different treatment options including systemic thrombolysis (ST) or catheter-directed thrombolysis (CDT) which can have the addition of ultrasound assistance. There is limited information regarding racial health disparities associated with these new treatments. We conducted a study to assess the difference in length of stay in patients of different races with PE who underwent ST or US-CDT. METHODS: This retrospective cohort study identified 1007 patients across several facilities diagnosed with Pulmonary Embolism. Patients who had pregnancy, stroke, and bleeding were not included. They were stratified into two groups based on the treatment they received, a group who underwent Ultrasound-Catheter-Directed Thrombolysis (US-CDT) with EKOS® (575 patients 57.1%), and a group who received Systemic Thrombolysis (ST) (432 patients 42.9%). Patients were subsequently divided based on race, patients which were black (n=140), white (n=778), and other (n=79). We assessed other patients’ characteristics such as hypertension (HTN), coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), and events during hospitalization. The primary goal was to compare the hospital length of stay with either treatment between patients of different races. Negative binomial regression was used to determine the association and prediction for the length of stay. RESULTS: Of the 1007 patients with PE who received either Ultrasound-Catheter-Directed or Systemic Thrombolysis, the mean age was 58.65 years, 45.78% were female and 54.22% were male; 77.26% were white, 14.9% were black and 7.85% were identified with other races The mean length of stay (LOS) was 7.41 days. The maximum length of stay was 143 days. There was no relationship between the type of treatment used for PE and the length of stay. Patients of black race compared to white patients are more likely with an incidence rate ratio (IRR) of 1.16 (P 0.02, CI 1.02~1.33) to have an extended length of stay. Patients who were of other races had also an increased IRR of 1.12 however it was not statistically significant (P 0.177, CI 0.94~1.34) CONCLUSIONS: It is well known that Black patients have an increased incidence of pulmonary embolism (PE) and associated mortality compared to other races. Our study is the first one to identify differences between races regarding outcomes related to the length of stay with the newer modalities of treatment including US-CDT. Patients of black race are more likely (IRR=1.16, p 0.02, CI 1.02~1.33) to have an extended length of stay. The study is limited by a relatively small sample. More research is needed to assess other confounding factors as well. CLINICAL IMPLICATIONS: Our study is the first one to identify differences between races regarding outcomes related to the length of stay with the newer modalities of treatment including US-CDT. DISCLOSURES: No relevant relationships by Robert Chait No disclosure on file for Nemanja Draguljevic No relevant relationships by Can Jones No relevant relationships by Kristina Menchaca No relevant relationships by Catherine Ostos No relevant relationships by Erika Ostos Perez No relevant relationships by Virginia Velez Quinones