Evidence map›Paper›PMID 42403305›Full record

ArticleCatheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions2026

Association of Hospital Volume With Outcomes of Pulmonary Embolism in the United States.

Zihan Gao, Troy N Coaston, Sidney Hinks, Nida Qadir, Obi Emeruwa, Peyman Benharash

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Zihan GaoCardiovascular Outcomes Research Laboratories (CORELAB), University of California Los Angeles, Los Angeles, California, USA.
Troy N CoastonCardiovascular Outcomes Research Laboratories (CORELAB), University of California Los Angeles, Los Angeles, California, USA.
Sidney HinksCardiovascular Outcomes Research Laboratories (CORELAB), University of California Los Angeles, Los Angeles, California, USA.
Nida QadirDivision of Pulmonary and Critical Care Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
Obi EmeruwaDivision of Pulmonary and Critical Care Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
Peyman BenharashCardiovascular Outcomes Research Laboratories (CORELAB), University of California Los Angeles, Los Angeles, California, USA.ORCID https://orcid.org/0009-0003-1867-4361

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPulmonary embolism (PE) remains a leading cause of mortality in the United States. While prior studies show improved outcomes at higher-volume centers, the understanding of procedural utilization remains limited.

aimsTherefore, this study aimed to evaluate the association of hospital PE volume and intervention utilization with clinical and financial outcomes in adult patients.

methodsAll non-elective adults (≥18 years) admitted for PE were identified using the 2016-2022 National Inpatient Sample. Annual PE admissions and intervention (mechanical thrombectomy, catheter-directed thrombolysis) caseloads were calculated for each facility. Centers were stratified by PE volume tertiles and classified as low- (LVH), medium- (MVH), and high-volume hospitals (HVH). Outcomes included in-hospital mortality, complications, length of stay, and inpatient costs. Multivariable regression and mixed-effect models were used to evaluate associations between hospital PE volume, intervention utilization, and outcomes.

resultsOf an estimated 1,475,860 PE hospitalizations, 12.4% and 57.2% were treated at LVH and HVH, respectively. Compared with HVH, LVH had higher unadjusted in-hospital mortality (10.7 vs. 6.0%, p < 0.001) and higher rates of cardiac and respiratory complications, while undergoing fewer interventions (5.2 vs. 7.2%, p < 0.001). Following risk adjustment, LVH remained associated with increased odds of in-hospital mortality (AOR 2.08, 95% CI 1.99-2.17), cardiac (AOR 1.16, 95% CI 1.09-1.24), and respiratory complications (AOR 1.11, 95% CI 1.07-1.14), and lower odds of receiving intervention (AOR 0.68, 95% CI 0.64-0.73). Higher institutional PE volume and intervention utilization were each independently associated with reduced mortality (p < 0.001). Notably, increasing PE volume mitigated differences in mortality associated with intervention utilization.

conclusionLower hospital PE volume was associated with higher mortality and complications. Additionally, intervention utilization was positively correlated with institutional PE caseload. Of note, higher PE admission volume was associated with improved outcomes regardless of treatment strategy. These findings suggest institutional experience may play a key role in high-quality PE care.

Indexed as

Hospitals, High-VolumeHospitals, Low-VolumeOutcome and Process Assessment, Health CareProcess Assessment, Health CarePulmonary EmbolismThrombectomyThrombolytic TherapyAdultAgedDatabases, FactualFemaleHospital CostsHospital MortalityHumansLength of StayMalehospital volumeintervention utilizationpatient outcomespulmonary embolism

Identifiers

PMID42403305
PMCPMC13532438

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.