Time to Mechanical Thrombectomy Does Not Impact In-Hospital Outcomes for Acute Submassive Pulmonary Embolism

Purpose: To determine if time to mechanical thrombectomy (MT) for submassive pulmonary embolism (PE) impacts length of hospital stay, 30-day readmission rate, and 30-day mortality rate.
Materials and Methods: Retrospective review of all patients that underwent MT for acute submassive PE with right heart strain from November 2019 to July 2022 were analyzed. Pediatric patients (age younger than 18 years) and massive PE were excluded from the study. Patient characteristics, comorbidities, vital signs, laboratory values (including cardiac biomarkers), hospital course, readmission rates, and 30-day mortality rates were recorded. Additionally, time from diagnosis of submassive PE on computed tomography scan to MT was also recorded and stratified as MT within 12 hours and MT after 12 hours of diagnosis. Pearson’s chi-squared and Student’s t-tests were used to compare the two cohorts. Additionally, multiple logistic regression analyses were performed to identify risk factors for 30-day readmission and mortality rates with statistical significance defined as P < 0.05.
Results: There were 69 patients (58.9 years; 56.5% female) with acute submassive PE that underwent MT with a technical success of 98.6% (n = 68) included in the study. Of these, 39% (n = 27) of patients underwent MT within 12 hours of diagnosis. There was no significant difference in length of hospital stay between the cohorts (8 ± 14.1 vs 6.9 ± 6 days; P = 0.7). Time to MT within 12 hours was not an independent risk factor for 30-day readmission (odds ratio [OR], 6.69, 95% confidence interval [CI], 0.03–99; P = 0.9) and 30-day mortality (OR, 0.33; 95% CI, 0.01–7.89; P = 0.9). However, increasing age was an independent risk factor for 30-day mortality (OR, 1.2, 95% CI, 1.03–1.48; P = .04).
Conclusions: MT within 12 hours from diagnosis of acute submassive PE does not significantly impact length of hospital stay, 30-day readmission rate, or 30-day mortality rate. However, older age was an independent risk factor for 30-day mortality.