Observation management of pulmonary embolism and agreement with claims-based and clinical risk stratification criteria in United States patients: a retrospective analysis

Table 1 Characteristics of pulmonary embolism patients managed through observation stays

Characteristic	IMPACT low-risk patients, n (%) N = 876	IMPACT higher-risk patients, n (%) N = 757	No high-risk criteria patients, n (%) N = 1,090	≥1 High-risk criteria patients, n (%) N = 543
Age (mean ± SD)	43.7 ± 12.3	70.1 ± 10.7	52.3 ± 15.8	63.4 ± 18.5
Male gender	385 (43.9)	340 (44.9)	503 (46.1)	222 (40.9)
High-risk criteria included in sPESI or Hestia criteria
Age >80 years	0 (0)	127 (16.8)	0 (0)	127 (23.4)
Heart failure	4 (0.5)	68 (9.0)	0 (0)	72 (13.3)
Chronic lung disease	91 (10.4)	226 (29.9)	0 (0)	317 (58.4)
Renal impairment	3 (0.3)	67 (8.9)	0 (0)	70 (12.9)
Severe liver disease	6 (0.7)	23 (3.0)	0 (0)	29 (5.3)
High risk for major bleeding^a	1 (0.1)	9 (1.2)	0 (0)	10 (1.8)
Cancer	0 (0)	46 (6.1)	0 (0)	46 (8.5)
Required thrombolysis or embolectomy (days 0–2)	2 (0.2)	2 (0.3)	0 (0)	4 (0.7)
Estimated IMPACT^b mortality risk, % (mean ± SD)	1.0 ± 0.3	3.2 ± 2.5	1.3 ± 0.7	3.4 ± 2.9
Myocardial infarction	1 (0.1)	0 (0)	0 (0)	1 (0.2)
Stroke	0 (0)	2 (0.3)	0 (0)	2 (0.4)
Atrial Fibrillation	3 (0.3)	85 (11.2)	31 (2.8)	57 (10.5)
Cognitive impairment	0 (0)	57 (7.5)	14 (1.3)	43 (7.9)
Coagulopathy	1 (0.1)	35 (4.6)	18 (1.7)	18 (3.3)
Length of stay, days (mean ± SD) (median [25%, 75% range])	2.1 ± 0.8 2.0 (2.0, 3.0)	2.4 ± 1.6 2.0 (2.0, 3.0)	2.2 ± 1.3 2.0 (2.0, 3.0)	2.3 ± 1.0 2.0 (2.0, 3.0)

IMPACT In-hospital Mortality for PulmonAry embolism using Claims daTa, SD standard deviation, sPESI simplified pulmonary embolism severity index
^aActive or recent history of major bleed
^bThe multivariable IMPACT equation is: 1/(1 + exp(−x); where x = −5.833 + (0.026*age) + (0.402*myocardial infarction) + (0.368*chronic lung disease) + (0.464*stroke) + (0.638*prior major bleeding) + (0.298*atrial fibrillation) + (1.061*cognitive impairment) + (0.554*heart failure) + (0.364*renal failure) + (0.484*liver disease) + (0.523*coagulopathy) + (1.068*cancer)

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