Background/Purpose: Autoimmune diseases are associated with a high prevalence of pulmonary embolism due to the inflammation-induced hyper coagulable state.This study aimed to analyze trends in the prevalence of rheumatic diseases among hospitalized patients with pulmonary embolism and their effects on mortality.

Methods: Using ICD-10 codes from the National Inpatient Sample (NIS) database, we identified adults hospitalized between January 2016 and December 2020 with primary diagnoses of pulmonary embolism, with or without secondary diagnoses of Behçet’s disease, scleroderma, antiphospholipid syndrome, or dermatomyositis. We assessed inpatient mortality as the primary outcome and analyzed secondary outcomes including length of stay (LOS) and total hospital charges. Logistic multivariate regression adjusted for age, race, hypertension, hyperlipidemia, diabetes mellitus, and various comorbidities.

Results: Among 933,139 hospitalized patients with pulmonary embolism (PE), 3,130 (0.33%) had antiphospholipid syndrome (APL), 130 (0.014%) had Behçet’s disease, 1,150 (0.12%) had scleroderma, and 115 (0.012%) had dermatomyositis. The overall mortality rate for PE was 3.14%. Specifically, mortality rates for patients with scleroderma, APL, Behçet’s disease, and dermatomyositis were 3.91%, 1.6%, 7.69%, and 0%, respectively. The mean length of stay for all PE patients was 4.3 days, whereas for patients with scleroderma, APL, Behçet’s disease, and dermatomyositis, it was 6.2, 5.5, 7, and 6.2 days, respectively. Total hospital charges for all PE patients averaged $49,998, compared to $66,589, $71,166, $93,177, and $51,530 for patients with scleroderma, APL, Behçet’s disease, and dermatomyositis, respectively.

Conclusion: Antiphospholipid syndrome appears to have the highest association with pulmonary embolism among these rheumatic diseases. However, scleroderma and Behçet’s disease exhibit poorer outcomes in terms of mortality, with Behçet’s disease showing the highest mortality rate. Moreover, these rheumatic diseases impose a significant burden on healthcare resources, as indicated by longer hospital stays and higher total charges compared to patients without these conditions. The coexistence of rheumatic diseases with pulmonary embolism imposes substantial strain on healthcare systems.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/impact-of-scleroderma-antiphospholipid-syndrome-behcets-disease-and-dermatomyositis-on-mortality-among-hospitalized-patients-with-pulmonary-embolism/