Emergency Department diagnosis of pulmonary embolism is associated with significantly reduced mortality: a linked data population study

Emerg Med Australas. 2009 Aug;21(4):269-76. doi: 10.1111/j.1742-6723.2009.01196.x.


Objectives: We characterized patients admitted via ED with a principal hospital discharge diagnosis of pulmonary embolism (PE) and compared mortality of those diagnosed in the ED with those diagnosed after admission.

Methods: Patients with a hospital discharge diagnosis ICD 10 I26 presenting to the ED in Perth, Western Australia between 1 July 2000 and 30 December 2006 had records from the Emergency Department Information System linked to the Western Australian Hospital Morbidity Data System and the death registry.

Results: Of 2250 patients (mean age 60.4), 1227 (54.5%) were female. Of 1931 patients with an ED diagnosis recorded, 1207 (62.5%) were diagnosed with PE in ED. Of these, 383 (17.0%) had presented to an ED within 28 days previously, 142 (37.1%) with either chest pain or breathing problems, with 207 (54.0%) admitted but not receiving a principal hospital discharge diagnosis of PE. There were 127 (5.6%) in-hospital deaths. Controlling for age and comorbidity with logistic regression, patients diagnosed with PE in ED were less likely to die in hospital, within 7 and 30 days of ED arrival, than those diagnosed after admission (adjusted OR 0.31, 95% CI 0.20-0.47; adjusted OR 0.32, 95% CI 0.19-0.53; adjusted OR 0.30, 95% CI 0.20-0.44; respectively).

Conclusion: Making the diagnosis of PE in ED was associated with a substantial survival advantage that persisted after hospital discharge.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Clinical Protocols
  • Cohort Studies
  • Emergency Service, Hospital*
  • Female
  • Hospital Mortality*
  • Humans
  • Male
  • Middle Aged
  • Patient Admission / statistics & numerical data
  • Pulmonary Embolism / diagnosis*
  • Pulmonary Embolism / mortality*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Western Australia / epidemiology
  • Young Adult