SHM Converge Scientific Abstract ePoster Gallery-Trends in Discharge Disposition to Home vs. Hospital in Emergency Department Management of Acute Venous Thromboembolism Using National Hospital Database

Trends in Discharge Disposition to Home vs. Hospital in Emergency Department Management of Acute Venous Thromboembolism Using National Hospital Database

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This retrospective analysis used the Premier Healthcare Database to examine emergency department (ED) encounters for acute venous thromboembolism (VTE) in U.S. hospitals from 2016 to 2020. The study included 437,277 encounters in adults aged 18 years or older: 41% deep vein thrombosis (DVT) and 59% pulmonary embolism (PE). Encounters were grouped by discharge disposition: inpatient/transfer, home from the ED, or home from observation.<br /><br />Overall, outpatient management increased over time for both DVT and PE. For DVT, discharge home from the ED rose from 42.0% in 2016 to 49.9% in 2020, while inpatient care declined from 50.0% to 41.4%. For PE, outpatient discharge also increased, but remained uncommon: home discharges rose from 5.7% to 8.7%, while inpatient care declined from 88.0% to 79.4%.<br /><br />Readmission outcomes were assessed within 30 days as either an ED visit or inpatient admission. Among all VTE encounters, 18% had an all-cause readmission and 3% had a VTE-related readmission. For DVT, all-cause readmission rates were similar across disposition types, ranging from 17.1% to 18.2%. For PE, all-cause readmission was numerically higher in patients discharged home (23.7%) than in those admitted inpatient (17.7%) or discharged from observation (19.5%). VTE-related readmissions were low for DVT (1.4%–2.6%) but higher for PE, especially among observation patients (15.2%).<br /><br />The authors concluded that outpatient management of VTE increased over time, especially for DVT, but remained low for PE. They noted that higher readmissions among outpatient PE patients warrant further study, particularly because the analysis could not determine VTE severity or outpatient eligibility.

Asset Subtitle

Julie Simonson

Meta Tag

Author List Britney Mazzetta, Charles Medico, Julie Simonson, Margarita Udall, Mohammad Ateya, Nathan Spence

Category Research

Concept Venous Thromboembolism

Concept Discharge Disposition

Concept Deep Vein Thrombosis

Concept Pulmonary Embolism

Concept Readmission

Distinguished Non-Finalist

Presenter Organization Pfizer Inc

Presenting Author Julie Simonson

Track Outcomes Research

Keywords

venous thromboembolism

emergency department

deep vein thrombosis

pulmonary embolism

outpatient management

hospital discharge

readmission rates

retrospective analysis

Premier Healthcare Database

observation status

Venous Thromboembolism

Discharge Disposition

Deep Vein Thrombosis

Pulmonary Embolism

Readmission