IM - ORIGINAL In-hospital mortality for pulmonary embolism: relationship with chronic kidney disease and end-stage renal disease. The hospital admission and discharge database of the Emilia Romagna region of Italy Fabio Fabbian • Massimo Gallerani • Marco Pala • Alfredo De Giorgi • Raffaella Salmi • Fabio Manfredini • Francesco Portaluppi • Francesco Dentali • Walter Ageno • Dimitri P. Mikhailidis • Roberto Manfredini Received: 10 August 2012 / Accepted: 3 December 2012 Ó SIMI 2012 Abstract The impact of chronic kidney disease (CKD) on the outcome of acute pulmonary embolism (PE) is uncertain. We aimed to evaluate the effect of renal dysfunction (defined by ICD-9-CM codification) on in-hospital mortality for PE. We considered all cases of PE (first event) recorded in the database of hospital admissions for the Emilia-Romagna region, Italy, from 1999 to 2009. The inclusion criterion was the presence, as a main discharge diagnosis, of acute PE codes according to ICD-9-CM. Diagnoses of immobiliza- tion, dementia, sepsis, skeletal fractures, hypertension, heart failure, myocardial infarction, diabetes mellitus, peripheral vascular disease, cerebrovascular disease, chronic pulmon- ary disease, pneumonia, malignancy, CKD and end-stage renal disease (ESRD) were also considered to evaluate comorbidity. The outcome was in-hospital mortality for PE, and multivariate logistic regression analyses was per- formed. We considered 24,690 cases of first episode of PE. In-hospital mortality for PE was not different in patients without renal dysfunction, with CKD, or ESRD (23.6 vs. 24 vs. 18 % p = ns). In-hospital mortality for PE was independently associated with age (OR 1.045, 95 % CI 1.042–1.048, p \ 0.001), female sex (OR 1.322, 95 % CI 1.242–1.406, p \ 0.001), hypertension (OR 1.096, 95 % CI 1.019–1.178, p = 0.013), diabetes mellitus (OR 1.120, 95 % CI 1.001–1.253, p = 0.049), dementia (OR 1.171, 95 % CI 1.020–1.346, p = 0.025), peripheral vascular F. Fabbian (&) Á M. Pala Á A. De Giorgi Clinica Medica, Azienda Ospedaliera-Universitaria, University of Ferrara, via Aldo Moro 8, 44124 Cona, Ferrara, Italy e-mail: f.fabbian@ospfe.it M. Pala e-mail: marco.pala@unife.it A. De Giorgi e-mail: degiorgialfredo@libero.it M. Gallerani First Unit of Internal Medicine, Azienda Ospedaliera-Universitaria, Ferrara, Italy e-mail: m.gallerani@ospfe.it R. Salmi Second Unit of Internal Medicine, Azienda Ospedaliera-Universitaria, Ferrara, Italy e-mail: raffaella.salmi@ospfe.it F. Manfredini Vascular Disease Center, Azienda Ospedaliera-Universitaria, University of Ferrara, Ferrara, Italy e-mail: fabio.manfredini@unife.it F. Portaluppi Clinica Medica and Hypertension Center, University Hospital S. Anna and University of Ferrara, Ferrara, Italy e-mail: francesco.portaluppi@unife.it F. Dentali Á W. Ageno Department of Clinical Medicine, University of Insubria, Varese, Italy e-mail: fdentali@libero.it W. Ageno e-mail: agewal@yahoo.com D. P. Mikhailidis Department of Clinical Biochemistry (Vascular Disease Prevention Clinics), University College London (UCL) Medical School, London, UK e-mail: MIKHAILIDIS@aol.com R. Manfredini Clinica Medica and Vascular Diseases Center, Azienda Ospedaliera-Universitaria, University of Ferrara, Ferrara, Italy e-mail: roberto.manfredini@unife.it 123 Intern Emerg Med DOI 10.1007/s11739-012-0892-8