Despite evidence suggesting that there are disparities in access to and quality of pulmonary embolism (PE) care, Hispanic and Latino patients have been underrepresented in PE healthcare disparities research. These individuals make up nearly a fifth of the U.S. population but have comprised less than 1% of existing PE study cohorts. To address this gap, NewYork-Presbyterian/
Despite evidence suggesting that there are disparities in access to and quality of pulmonary embolism (PE) care, Hispanic and Latino patients have been underrepresented in PE healthcare disparities research. These individuals make up nearly a fifth of the U.S. population but have comprised less than 1% of existing PE study cohorts. To address this gap, NewYork-Presbyterian/
Sanjum Sethi, MD
"Since we serve a large community of Hispanic and Latino patients, we were uniquely positioned to complete this study to evaluate differences in care among this population," says Sanjum Sethi, MD, senior author of the study and an interventional and Director of the multidisciplinary Pulmonary Embolism Response Team (PERT)at NewYork-Presbyterian/
Hispanic and Latino individuals are also more likely to have co-morbidities such as diabetes, cardiovascular disease, and stroke. "These patients are pretty sick at baseline. We were a little surprised that they came in with lower severity PE," explains study co-author Daniel Snyder, MD, an internal medicine resident at NewYork-Presbyterian/
Despite having lower-severity PE, Hispanic and Latino patients had in-hospital and 30-day mortality rates that were comparable to patients with higher-risk PE.
— Dr. Daniel Snyder
Daniel Snyder, MD
The researchers reviewed all PE cases at Columbia from 2013 to 2019; 1,265 patients were confirmed to have PE, including 474 who identified as Hispanic or Latino. They found that Hispanic or Latino patients presented with high-risk PE significantly less often than non-Hispanic or Latino patients (19% versus 25%, respectively). Hispanics/
"We need to dive deeper and do more research to understand what is going on. One presumption is that there is something that is unique or different about these patients to explain why they have the same rate of in-hospital mortality even though they have lower-risk PE," says Dr. Sethi. "As cardiovascular and pulmonary specialists, we have a lot of ground to cover to better understand patients with pulmonary embolism, who is most at risk, and what are their outcomes."
In addition to medical treatments and surgery, new catheter-based therapies are changing the landscape of pulmonary embolism care. Dr. Sethi and his fellow investigators are broadening their analysis to include four more years of data that may glean more insights into outcomes among Hispanic and Latino patients.
As cardiovascular and pulmonary specialists, we have a lot of ground to cover to better understand patients with pulmonary embolism, who is most at risk, and what are their outcomes.
— Dr. Sanjum Sethi
Physicians are advised to consider these disparities when treating their Hispanic and Latino patients. "Take extra care with this population, knowing that our risk categorization is under-predicting what their mortality may actually be," Dr. Snyder notes. "Keep a high index of suspicion when a patient comes in with shortness of breath, tachycardia, and elevated respiratory rate." PERT is available for patient visits or telephone consultations with referring physicians.
"We really want to be a resource for everyone to ensure these patients are being taken care of," adds Dr. Sethi. "The mortality rates for acute PE remain unacceptably high. And these patients require diligent and dedicated follow-up, which is lacking in many healthcare systems."
