Table 2.
Primary and secondary outcomes
| Age and sex matched* | Matched and adjusted for clinical characteristics † | Matched and adjusted for clinical and socioeconomic characteristics ‡ | ||||||
|---|---|---|---|---|---|---|---|---|
| Primary outcome | Risk ratio (95% CIs) § | P value | Risk ratio (95% CIs) | P value | Risk ratio (95% CIs) | P value | ||
| Pulmonary embolism severity | NA | NA | 1.08 (1.03–1.14) | 0.003 | 1.13 (1.01–1.27) | 0.003 | 1.05 (1.05–1.35) | 0.002 |
| Secondary outcome (in‐hospital) || | White (N=3264), No. events (%) | Black (N=1210), No. events (%) | Risk ratio (95% CIs) § | P value | Risk ratio (95% CIs) | P value | Risk ratio (95% CIs) | P value |
| Any intervention | 354 (10.9%) | 94 (7.8%) | 0.77 (0.66–0.89) | 0.001 | 0.73 (0.64–0.84) | <0.001 | 0.72 (0.63–0.83) | <0.001 |
| Severity subgroup | <0.001 | <0.001 | <0.001 | |||||
| Intermediate risk | 306 (9.4%) | 71 (5.9%) | 0.68 (0.57–0.80) | <0.001 | 0.65 (0.56–0.75) | <0.001 | 0.63 (0.54–0.75) | <0.001 |
| High risk | 48 (1.5%) | 23 (1.9%) | 1.51 (1.29–1.77) | <0.001 | 1.45 (1.36–1.55) | <0.001 | 1.45 (1.37–1.55) | <0.001 |
| Systemic therapeutic intervention | 0.47 (0.18–1.22) | 0.120 | 0.46 (0.15–1.34) | <0.001 | 0.43 (0.21–0.91) | 0.030 | ||
| Severity subgroup | 0.050 | <0.001 | <0.001 | |||||
| Intermediate risk | 28 (1.0%) | 2 (0.2%) | 0.29 (0.09–1.02) | 0.050 | 0.27 (0.09–0.88) | 0.030 | 0.24 (0.13–0.45) | <0.001 |
| High risk | 12 (8.5%) | 6 (10.2%) | 1.14 (0.94–1.38) | 0.180 | 1.41 (0.91–2.19) | 0.120 | 1.58 (0.8–3.13) | 0.190 |
| Targeted therapeutic interventions # | 0.67 (0.44–1.03) | 0.070 | 0.65 (0.43–0.98) | 0.040 | 0.65 (0.41–10.5) | 0.080 | ||
| Severity subgroup | <0.001 | <0.001 | <0.001 | |||||
| Intermediate risk | 150 (5.6%) | 25 (2.5%) | 0.52 (0.29–0.93) | 0.030 | 0.48 (0.27–0.86) | 0.010 | 0.48 (0.25–0.94) | 0.030 |
| High risk | 19 (13.4%) | 10 (17.0%) | 3.03 (2.57–3.56) | <0.001 | 3.76 (3.05–4.63) | <0.001 | 3.51 (2.5–4.94) | <0.001 |
| Preventative intervention | 0.9 (0.82–0.99) | 0.040 | 0.81 (0.79–0.82) | <0.001 | 0.78 (0.75–0.82) | <0.001 | ||
| Severity subgroup | 0.470 | 0.960 | 0.920 | |||||
| Intermediate risk | 140 (5.2%) | 45 (4.5%) | 0.81 (0.71–0.92) | 0.001 | 0.80 (0.72–0.9) | <0.001 | 0.78 (0.73–0.84) | <0.001 |
| High risk | 32 (23.5%) | 14 (23.7%) | 1.00 (0.63–1.57) | 0.990 | 0.82 (0.48–1.39) | 0.460 | 0.8 (0.49–1.32) | 0.390 |
| Mortality** | 0.83 (0.69–1.01) | 0.060 | 0.81 (0.61–1.07) | 0.150 | 0.76 (0.54–1.06) | 0.100 | ||
| Severity subgroup | 0.390 | 0.900 | 0.500 | |||||
| Intermediate risk | 33 (1.2%) | 8 (0.8%) | 0.65 (0.39–1.08) | 0.090 | 0.80 (0.46–1.40) | 0.430 | 0.85 (0.48–1.50) | 0.570 |
| High risk | 50 (35.5%) | 18 (30.5%) | 0.81 (0.63–1.03) | 0.090 | 0.83 (0.67–1.02) | 0.090 | 0.69 (0.52–0.92) | 0.010 |
Matched 1:3 (Black:White) on age and sex without replacement (89% 1:3 pairs; 9% 1:2 pairs; 2% 1:1 pairs). Regression analysis of secondary outcomes include pulmonary embolism severity covariates.
Adjusted clinical characteristics included in the ordinal regression (severity) and Fine‐Gray models (interventions), and logistic regression (in‐hospital mortality) include race, age, sex, body mass index ≥35 mg/kg, recent surgery in the last 90 d, prior venous thromboembolism, and aspirin use.
Adjusted clinical and socioeconomic characteristics included in the ordinal regression (severity) and Fine‐Gray models (interventions), and logistic regression (in‐hospital mortality) are expanded to include the Area of Deprivation Index, and insurance status.
Ordinal (low‐, intermediate, and high‐risk pulmonary embolism) logistic regression evaluating the risk of interest, clustered on hospital size (Tables S6 through S7). Risk ratios corresponding to odds ratios for the primary and mortality outcomes, subdistribution hazard ratios for intervention related secondary outcomes. Of note, the reported subdistribution hazard ratios are reported to demonstrate the direction of the effect, their quantification of the magnitude of this effect on the cumulative incidence must be considered an approximation. 27
Interventions as defined by Current Procedural Terminology codes (Table S1).
Only among hospitalizations for intermediate and high‐risk pulmonary embolisms
The average time to death was 6.42±7.37 d for Black patients (n=24), and 4.24±5.91 d for White patients (n=83). This was not different between groups (P=0.150).