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Pulmonary Embolism Patients Fare Better At High-Volume Hospitals: Study

New research suggests that patients admitted to high volume hospitals for pulmonary embolisms may be more likely to survive than those taken to hospitals that admit fewer patients.

Spanish researchers published a study late last month in the medical journal The BMJ, which found an association between high-volume hospitals and the likelihood someone who just suffered a blood clot that has traveled to the lungs will survive that first month after the incident.

Researchers performed a multinational population-based study involving 353 hospitals across 16 countries to evaluate whether an association between experiences in the management of acute pulmonary embolism (PE) determined patient outcome. The management experiences were broken down into either high or low volume hospital settings.

The study involved 39,257 consecutive patients with confirmed diagnosis of acute symptomatic pulmonary embolism, and categorized the cases by high or low volume hospitals setting.

Data indicated hospitals with higher patient volume experienced approximately 44 percent less fatalities within 30 days of the pulmonary embolism being diagnosed compared to low volume hospitals.

Researchers believe this could be because medical teams at low volume hospitals are less experienced diagnosis and proper treatment of pulmonary emboli, which could result in adverse patient outcomes.

They also noted that high volume hospitals routinely treat elderly patients and those who have history or recently experienced strokes or myocardial infarctions, which could make the presence of patient pulmonary embolism more recognizable. Patients admitted to higher volume hospitals  also had more comorbid diseases such as cancer, chronic lung disease, congestive heart failure, and recent bleeding, signaling more signs of clinical severity.

The researchers warned that additional research is still needed to determine whether strategies to improve clinical expertise in low volume hospital settings could improve the mortality rates.

Pulmonary embolisms are among the most common cause of vascular death, especially for individuals who have recently suffered heart attacks or strokes. The condition occurs when a blockage accumulates in one of the pulmonary arteries in the lungs, which may result in instantaneous cardiac arrest. These conditions are often the result of an unknown blood clot in the legs that detaches and travels to the lungs.

The exact number PE fatalities annually is unknown, however in the United States, an estimated 71 to 117 people per 100,000 are diagnosed with pulmonary embolism each year. Approximately 10% to 30% die within the first month after diagnosis.

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