Pulmonary Embolectomy in Elderly Patients

Abstract Objective The relation of age to case fatality rate in patients undergoing pulmonary embolectomy has not been reported. In view of the importance of age in the selection of patients who may be candidates for pulmonary embolectomy, we explored the database of the Nationwide Inpatient Sample to determine the impact of age on the case fatality rate. Methods Patients with pulmonary embolism who underwent pulmonary embolectomy in short-stay hospitals throughout the United States, 1999-2008, were identified from the Nationwide Inpatient Sample. In-hospital all-cause case fatality rate was assessed according to age. Results The proportion of patients who underwent pulmonary embolectomy decreased with age among both stable and unstable patients. Case fatality rate with pulmonary embolectomy in stable patients increased with age beginning at age 51 to 60 years. Among patients aged 51 to 60 years, the case fatality rate was 100 of 575 (17.4%). This rate increased to 60 of 130 (46.2%) among patients aged more than 80 years ( P < .0001). The case fatality rate did not correlate with age in unstable patients. Conclusions The case fatality rate with pulmonary embolectomy in stable patients increases with age greater than 51 to 60 years and is high among the elderly. The case fatality rate with pulmonary embolectomy in unstable patients does not seem to be related to age.