Treatment of Unstable Pulmonary Embolism in the Elderly and Those with Comorbid Conditions

Abstract Background Although the in-hospital case fatality rate is lower in unstable patients with pulmonary embolism who receive thrombolytic therapy, less than one third receive it. The purpose of this investigation is to try to assess why most unstable patients fail to receive thrombolytic therapy and whether evidence might support a more aggressive approach. Methods Data were obtained from the Nationwide Inpatient Sample 1999-2008. Results Fewer unstable patients with pulmonary embolism accompanied by comorbid conditions received thrombolytic therapy than patients with no comorbid conditions, 11,670 of 60,100 (19.4%) vs 9710 of 12,130 (80.0%) ( P 60 years received thrombolytic therapy than patients aged ≤ 60 years, both among those with comorbid conditions, 6330 of 37,320 (17.0%) vs 5340 of 22,780 (23.4%) ( P