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Said A. Ibrahim, MD, MPH, Roslyn A. Stone, PhD, D. Scott Obrosky, MSc, Jennifer Sartorius, MSc, Michael J. Fine, MD, MSc and Drahomir Aujesky, MD, MSc

Said A. Ibrahim, Michael J. Fine, Roslyn A. Stone, D. Scott Obrosky, and Jennifer Sartorius are with the Veterans Administration Center for Health Equity Research and Promotion, Pittsburgh Healthcare System, Pittsburgh, Pa. Said A. Ibrahim, Michael J. Fine, and D. Scott Obrosky are also with the Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh. Roslyn A. Stone is also with the Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh. Drahomir Aujesky is with the Division of Internal Medicine, the Clinical Epidemiology Center, and the University Outpatient Clinic, University of Lausanne, Lausanne, Switzerland.

Correspondence: Requests for reprints should be sent to Said A. Ibrahim, MD, MPH, Veterans Administration Center for Health Equity Research and Promotion, Pittsburgh Healthcare System, University Drive C (151C-U), Pittsburgh, PA 15240 (e-mail: said.ibrahim2{at}va.gov).

Objectives. Previous studies reported a higher incidence of in-hospital mortality for Black patients who had pulmonary embolism than for White patients. We used a large statewide database to compare 30-day mortality (defined as death within 30 days from the date of latest hospital admission) for Black and White patients who were hospitalized because of pulmonary embolism.

Methods. The study cohort consisted of 15531 discharged patients who had been treated for pulmonary embolism at 186 Pennsylvania hospitals between January 2000 and November 2002. We used random-effects logistic regression to model 30-day mortality for Black and White patients, and adjusted for patient demographic and clinical characteristics.

Results. The unadjusted 30-day mortality rates were 9.0% for White patients, 10.3% for Blacks, and 10.9% for patients of other or unknown race. When adjusted for severity of disease using a validated clinical prognostic model for pulmonary embolism, Black patients had 30% higher odds of 30-day mortality compared with White patients at the same site (adjusted odds ratio = 1.3; 95% confidence interval, 1.1,1.6). Neither insurance status nor hospital volume was a significant predictor of 30-day mortality.

Conclusion. Black patients who had pulmonary embolism had significantly higher odds of 30-day mortality compared with White patients.

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