Smokers With Pulmonary Embolism Have an Increased Risk of Hospital Readmission
By Eric Ramos
NEW ORLEANS -- October 22, 2019 -- Among patients hospitalised due to a pulmonary embolism, those who smoked were more likely to be readmitted within 30 days of discharge, according to a study presented here at the 2019 Annual Meeting of the American College of CHEST Physicians (CHEST 2019).
In the study, 11.0% of smokers were readmitted to the hospital within 30 days of discharge compared with 8.9% of nonsmokers (P
Patients who were readmitted had a significantly higher mortality rate compared with index admissions (6.27 % vs 3.16%; P
The finding that so many patients admitted for a pulmonary embolism smoke is concerning, especially because they have a higher risk of readmission and death. These poor outcomes prompt an urgent need for in-hospital smoking cessation services.
“Previous reports have shown that smoking cessation services are underutilised within the hospital,” said Kam Sing Ho, MD, Mount Sinai Hospital, New York, New York. “In the future, we want to incorporate smoking cessation services for all adults hospitalised with pulmonary emboli.”
For the study, the researchers analysed data from the AHRQ-HCUP Nationwide Readmission Database for the year 2014. The researchers identified 171.233 hospital admissions for pulmonary embolism. Of the patients, 34.2% smoked. The outcomes of 24,262 patients with pulmonary embolism who smoked were compared with 24,262 patients with pulmonary embolism who did not smoke.
Tobacco dependence was an independent predictor for hospital readmission (hazard ratio = 1.29; 95% confidence interval, 1.04-1.59; P
“This study provides an opportunity to evaluate methods of implementing tobacco cessation, in light of possible increased risk of pulmonary embolism in smokers,” commented Michelle Cao, MD, Stanford University, Stanford, California. “One of the questions posed is how can we better utilise in- hospital smoking cessation programs as well as outpatient programs. Can this service be driven by primary care providers and/or pulmonologists? Successful smoking cessation programs would have major implications on morbidity, mortality as well as economic burden.”
[Presentation title: Is Smoking Worth the Risk? Increased 30-Day Readmission Among Smokers With Pulmonary Embolism: a Propensity Score Match Analysis. Poster E1136]