Racial Differences in Early vs Late Mechanical Thrombectomy Outcomes for PE With Entropy Balancing

Monday, March 23, 2026

11:30 AM - 12:30 PM Central Time

Location: Connections Central - RST 13

GC

Giorgi Chilingarashvili, MD, MSc

Disclosure(s): No relevant financial relationship(s) to disclose.
KP

Krunal Patel, MD

PCCM Fellow
Temple University Hospital

Disclosure information not submitted.
KO

Konstantin Ozerinsky, MD

Internal Medicine Specialist
Nazareth Hospital

Disclosure information not submitted.
VR

Vakhtang Robakidze, MD

Post Graduate
GAU

Disclosure information not submitted.
CB

Cauvery Balhara Taank, MD

IM Resident
Nazareth Hospital

Disclosure information not submitted.
FC

Franco Campoli, MD

Nazareth Hospital

Disclosure(s): No relevant financial relationship(s) to disclose.
AM

Avilash Mondal, MD

IM Resident
Nazareth Hospital

Disclosure information not submitted.
JP

Joshua Pregnar, DO

Critical Care Intensivist
Sound Physicians

Disclosure information not submitted.
RF

Rotem Friede, MD

Critical Care Intensivist
Nazareth Hospital

Disclosure information not submitted.

Introduction: Pulmonary embolism (PE) is a critical condition often treated with mechanical thrombectomy, where timing may influence outcomes. Racial disparities in cardiovascular care are known, but evidence on race-specific thrombectomy timing in PE is limited. This study examines early (≤24 hours) versus late (>24 hours) thrombectomy outcomes in White and Black patients, using entropy balancing for confounder adjustment.

Methods: This retrospective cohort study used 2022 NIS data to evaluate early versus late mechanical thrombectomy outcomes in adult PE patients (>18 years), stratified by race (White and Black). Patients were identified via ICD-10 codes for PE and thrombectomy, with non-elective admissions included. Entropy balancing adjusted for comorbidities, and survey-weighted logistic regression estimated adjusted odds ratios (ORs) for outcomes.

Results: Mean age was similar (early: 58.6 years; late: 59.2 years; p>0.05). Late thrombectomy increased length of stay by 2.97 days (p=0.0001). Baseline characteristics were balanced, except late thrombectomy was more common in teaching hospitals (p=0.039). For White patients, early thrombectomy reduced blood transfusion needs (OR 0.58, p=0.01) but showed no significant differences in AKI, mortality, stroke, or MACE. For Black patients, early thrombectomy lowered stroke (OR 0.02, p=0.001) and MACCE risks (OR 0.15, p=0.001), with no significant differences in other outcomes. Wide confidence intervals suggest limited statistical power.

Conclusions: Early thrombectomy reduced transfusion needs in White patients and stroke/MACCE risks in Black patients, indicating race-specific benefits. Late thrombectomy increased hospital stay. Entropy balancing minimized confounding, but unmeasured factors like care access may influence results. Tailored timing strategies and further research are needed to optimize outcomes and address disparities.