Pulmonary embolism (PE) is the third leading cause of cardiovascular death in the United States. Black Americans have higher incidence, greater clot severity, and worse outcomes than White Americans. This disparity is not fully understood, especially in the context of the advent of PE response teams (PERT), which aim to standardize PE-related care. This retrospective single-center cohort study compared 294 Black and 131 White patients from our institution's PERT database. Primary objectives included severity and in-hospital management. Secondary outcomes included length of stay, 30-day readmission, 30-day mortality, and outpatient follow-up. Clot (p = 0.42), acute treatment (p = 0.28), 30-day mortality (p = 0.77), 30-day readmission (p = 0.50), and outpatient follow-up (p = 0.98) were similar between races. Black patients had a lower mean household income ($35,383, SD 20,596) than White patients ($63,396, SD 32,987) (p < 0.0001). More Black patients (78.8%) had exclusively government insurance (Medicare/Medicaid) compared to White patients (61.8%) (p = 0.006). Interestingly, government insurance patients had less follow-up (58.3%) than private insurance patients (79.7%) (p = 0.001). Notably, patients with follow-up had fewer 30-day readmissions. Specifically, 12.2% of patients with follow-up were readmitted compared to 22.2% of patients without follow-up (p = 0.008). There were no significant differences in PE severity, in-hospital treatment, mortality, or readmissions between Black and White patients. However, patients with government insurance had less follow-up and more readmissions, indicating a socioeconomic disparity. Access barriers such as health literacy, treatment cost, and transportation may contribute to this inequity. Improving access to follow-up care may reduce the disparity in PE outcomes.

中文翻译：

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PERT 时代，大型城市安全网医院中基于种族的医疗保健差异

肺栓塞（PE）是美国心血管死亡的第三大原因。与美国白人相比，美国黑人的发病率更高、血栓严重程度更严重、预后更差。这种差异尚未得到充分理解，特别是在 PE 响应小组 (PERT) 出现的背景下，该小组旨在标准化 PE 相关护理。这项回顾性单中心队列研究比较了我们机构 PERT 数据库中的 294 名黑人和 131 名白人患者。主要目标包括严重程度和院内管理。次要结局包括住院时间、30 天再入院、30 天死亡率和门诊随访。不同种族之间的血栓 ( p  = 0.42)、急性治疗 ( p  = 0.28)、30 天死亡率 ( p  = 0.77)、30 天再入院 ( p  = 0.50) 和门诊随访 ( p  = 0.98) 相似。黑人患者的平均家庭收入（35,383 美元，标准差 20,596）低于白人患者（63,396 美元，标准差 32,987）（p  < 0.0001）。与白人患者 (61.8%) 相比，更多黑人患者 (78.8%) 仅拥有政府保险（医疗保险/医疗补助）（p  = 0.006）。有趣的是，政府保险患者的随访率 (58.3%) 少于私人保险患者 (79.7%) ( p  = 0.001)。值得注意的是，进行随访的患者 30 天再入院的情况较少。具体而言，有随访的患者中有 12.2% 再次入院，而没有随访的患者中有 22.2% 再次入院 ( p  = 0.008)。黑人和白人患者在肺栓塞严重程度、住院治疗、死亡率或再入院方面没有显着差异。然而，拥有政府保险的患者随访较少，再入院率较高，这表明存在社会经济差异。健康素养、治疗费用和交通等准入障碍可能会加剧这种不平等。改善后续护理的可及性可能会减少PE结果的差异。