Abstract
Introduction: Pulmonary embolism (PE) poses substantial morbidity and mortality risks, necessitating timely and accurate management in emergency departments (EDs). Objectives: This study explores the trends in PE presentations to US EDs from 2006 to 2018 and assesses the impact of different factors on management and cost. Methodology: This is a retrospective descriptive study conducted using the US Healthcare Cost and Utilization Project (HCUP) PE ED visits database. Data on ED visits, dispositions, and related costs were collected and analyzed. Results: From 2006 to 2018 there were more than 2 million PE ED visits in the US. There was an increase in visits per 100,000 persons from 42.17 in 2006-2008 to 64.27 in 2016-2018 (p value < 0.001). The proportion of uninsured patients declined from 5.07% to 4.70%, and the percentage of Medicaid-insured patients increased. There was a decrease in the admission rates from 92.47% to 75.97% in 2016-2018 (p value < 0.001). The mean cost per admitted patient increased from $32,794 to $47,344 in 2016-2018 (p value < 0.001). Conclusion: From 2006 to 2018, PE ED visits in the US increased with a noticeable decrease in admission rates and length of stay, likely secondary to advancement in diagnostic and therapeutic modalities like computed tomography pulmonary angiography and novel oral anticoagulants. However, the observed rising healthcare costs pose challenges to sustainable management. Further research studies are needed to address cost-effective strategies.