Internal and Emergency Medicine

, Volume 8, Issue 8, pp 735–740

In-hospital mortality for pulmonary embolism: relationship with chronic kidney disease and end-stage renal disease. The hospital admission and discharge database of the Emilia Romagna region of Italy

  • Fabio Fabbian
  • Massimo Gallerani
  • Marco Pala
  • Alfredo De Giorgi
  • Raffaella Salmi
  • Fabio Manfredini
  • Francesco Portaluppi
  • Francesco Dentali
  • Walter Ageno
  • Dimitri P. Mikhailidis
  • Roberto Manfredini
IM - ORIGINAL

DOI: 10.1007/s11739-012-0892-8

Cite this article as:
Fabbian, F., Gallerani, M., Pala, M. et al. Intern Emerg Med (2013) 8: 735. doi:10.1007/s11739-012-0892-8

Abstract

The impact of chronic kidney disease (CKD) on the outcome of acute pulmonary embolism (PE) is uncertain. We aimed to evaluate the effect of renal dysfunction (defined by ICD-9-CM codification) on in-hospital mortality for PE. We considered all cases of PE (first event) recorded in the database of hospital admissions for the Emilia-Romagna region, Italy, from 1999 to 2009. The inclusion criterion was the presence, as a main discharge diagnosis, of acute PE codes according to ICD-9-CM. Diagnoses of immobilization, dementia, sepsis, skeletal fractures, hypertension, heart failure, myocardial infarction, diabetes mellitus, peripheral vascular disease, cerebrovascular disease, chronic pulmonary disease, pneumonia, malignancy, CKD and end-stage renal disease (ESRD) were also considered to evaluate comorbidity. The outcome was in-hospital mortality for PE, and multivariate logistic regression analyses was performed. We considered 24,690 cases of first episode of PE. In-hospital mortality for PE was not different in patients without renal dysfunction, with CKD, or ESRD (23.6 vs. 24 vs. 18 % p = ns). In-hospital mortality for PE was independently associated with age (OR 1.045, 95 % CI 1.042–1.048, p < 0.001), female sex (OR 1.322, 95 % CI 1.242–1.406, p < 0.001), hypertension (OR 1.096, 95 % CI 1.019–1.178, p = 0.013), diabetes mellitus (OR 1.120, 95 % CI 1.001–1.253, p = 0.049), dementia (OR 1.171, 95 % CI 1.020–1.346, p = 0.025), peripheral vascular disease (OR 1.349, 95 % CI 1.057–1.720, p = 0.016) and malignancy (OR 1.065, 95 % CI 1.016–1.116, p = 0.008). Age and comorbidity are associated with in-hospital mortality for PE, whereas CKD does not appear to be an independent predictor of adverse outcomes in patients hospitalized for PE.

Keywords

Pulmonary embolismMortalityChronic kidney diseaseEnd-stage renal diseaseComorbidityICD-9-CM codification

Copyright information

© SIMI 2012

Authors and Affiliations

  • Fabio Fabbian
    • 1
  • Massimo Gallerani
    • 2
  • Marco Pala
    • 1
  • Alfredo De Giorgi
    • 1
  • Raffaella Salmi
    • 3
  • Fabio Manfredini
    • 4
  • Francesco Portaluppi
    • 5
  • Francesco Dentali
    • 6
  • Walter Ageno
    • 6
  • Dimitri P. Mikhailidis
    • 7
  • Roberto Manfredini
    • 8
  1. 1.Clinica MedicaAzienda Ospedaliera-Universitaria, University of FerraraCona, FerraraItaly
  2. 2.First Unit of Internal MedicineAzienda Ospedaliera-UniversitariaFerraraItaly
  3. 3.Second Unit of Internal MedicineAzienda Ospedaliera-UniversitariaFerraraItaly
  4. 4.Vascular Disease CenterAzienda Ospedaliera-Universitaria, University of FerraraFerraraItaly
  5. 5.Clinica Medica and Hypertension CenterUniversity Hospital S. Anna and University of FerraraFerraraItaly
  6. 6.Department of Clinical MedicineUniversity of InsubriaVareseItaly
  7. 7.Department of Clinical Biochemistry (Vascular Disease Prevention Clinics)University College London (UCL) Medical SchoolLondonUK
  8. 8.Clinica Medica and Vascular Diseases CenterAzienda Ospedaliera-Universitaria, University of FerraraFerraraItaly