Differences in referral to a chronic thromboembolic pulmonary hypertension center following acute pulmonary embolism: a locoregional experience
Abstract Chronic thromboembolic pulmonary hypertension (CTEPH) is a treatable complication of acute pulmonary embolism (PE). Identification of factors that impact referral to a comprehensive CTEPH center may improve disease awareness and patient outcomes. We conducted a study of patients with acute PE. Cases were identified through a natural language processing algorithm. ICD coding was used to assess clinical documentation for dyspnea or CTEPH placed at least 90 days after their acute PE diagnosis. We analyzed characteristics of patients who were referred vs. not referred, as well as referral patterns for “at risk” patients. 2454 patients with acute PE were identified, of which 4.9% (120/2454) were referred for CTEPH evaluation. Patients who were not referred were older (61 vs. 54 years, p < 0.001), had higher rates of cancer (28% vs. 10%, p < 0.001), and lived further from the referral center (9.1 miles vs. 6.7 miles, p = 0.03). Of 175 patients identified as “at risk,” 12% (21/175) were referred. In the ‘at risk’ cohort, distance from referral center among referred and not referred was significant (5.7 miles vs. 8.8 miles, p = 0.04). There were low rates of referral to CTEPH center in post-PE patients, and in patients with symptoms who may be at higher risk of CTEPH. Age, co-morbid conditions, distance from comprehensive center, and presence of a primary care provider contribute to differences in referral to a comprehensive CTEPH center. Clinician education about CTEPH is important to ensure optimal care to patients with or at risk for chronic complications of acute PE..
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:55 |
|---|---|
| Enthalten in: |
Journal of thrombosis and thrombolysis - 55(2023), 4 vom: 12. Feb., Seite 691-699 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Mylvaganam, Ruben [VerfasserIn] |
|---|
| Links: |
Volltext [lizenzpflichtig] |
|---|
| Themen: |
Chronic thromboembolic pulmonary hypertension |
|---|
| Anmerkungen: |
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
|---|
| doi: |
10.1007/s11239-023-02781-2 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
SPR050228951 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | SPR050228951 | ||
| 003 | DE-627 | ||
| 005 | 20230429064736.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 230429s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s11239-023-02781-2 |2 doi | |
| 035 | |a (DE-627)SPR050228951 | ||
| 035 | |a (SPR)s11239-023-02781-2-e | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Mylvaganam, Ruben |e verfasserin |0 (orcid)0000-0002-7203-7609 |4 aut | |
| 245 | 1 | 0 | |a Differences in referral to a chronic thromboembolic pulmonary hypertension center following acute pulmonary embolism: a locoregional experience |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. | ||
| 520 | |a Abstract Chronic thromboembolic pulmonary hypertension (CTEPH) is a treatable complication of acute pulmonary embolism (PE). Identification of factors that impact referral to a comprehensive CTEPH center may improve disease awareness and patient outcomes. We conducted a study of patients with acute PE. Cases were identified through a natural language processing algorithm. ICD coding was used to assess clinical documentation for dyspnea or CTEPH placed at least 90 days after their acute PE diagnosis. We analyzed characteristics of patients who were referred vs. not referred, as well as referral patterns for “at risk” patients. 2454 patients with acute PE were identified, of which 4.9% (120/2454) were referred for CTEPH evaluation. Patients who were not referred were older (61 vs. 54 years, p < 0.001), had higher rates of cancer (28% vs. 10%, p < 0.001), and lived further from the referral center (9.1 miles vs. 6.7 miles, p = 0.03). Of 175 patients identified as “at risk,” 12% (21/175) were referred. In the ‘at risk’ cohort, distance from referral center among referred and not referred was significant (5.7 miles vs. 8.8 miles, p = 0.04). There were low rates of referral to CTEPH center in post-PE patients, and in patients with symptoms who may be at higher risk of CTEPH. Age, co-morbid conditions, distance from comprehensive center, and presence of a primary care provider contribute to differences in referral to a comprehensive CTEPH center. Clinician education about CTEPH is important to ensure optimal care to patients with or at risk for chronic complications of acute PE. | ||
| 650 | 4 | |a Referral |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Differences |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Chronic thromboembolic pulmonary hypertension |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Dyspnea |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Venous thromboembolic event |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Lawrence, Romy |4 aut | |
| 700 | 1 | |a Goldberg, Isaac |4 aut | |
| 700 | 1 | |a Rahaghi, Farbod |4 aut | |
| 700 | 1 | |a Chiu, Stephen |4 aut | |
| 700 | 1 | |a Malaisrie, S. Christopher |4 aut | |
| 700 | 1 | |a Schimmel, Daniel |4 aut | |
| 700 | 1 | |a Avery, Ryan |4 aut | |
| 700 | 1 | |a Martin, Karlyn |4 aut | |
| 700 | 1 | |a Cuttica, Michael J. |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of thrombosis and thrombolysis |d Dordrecht [u.a.] : Springer Science + Business Media B.V, 1994 |g 55(2023), 4 vom: 12. Feb., Seite 691-699 |w (DE-627)SPR018007317 |w (DE-600)2017305-2 |x 1573-742X |7 nnns |
| 773 | 1 | 8 | |g volume:55 |g year:2023 |g number:4 |g day:12 |g month:02 |g pages:691-699 |
| 856 | 4 | 0 | |u https://dx.doi.org/10.1007/s11239-023-02781-2 |z lizenzpflichtig |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_SPRINGER | ||
| 951 | |a AR | ||
| 952 | |d 55 |j 2023 |e 4 |b 12 |c 02 |h 691-699 | ||