Zghouzi Mohamed, Mwansa Hunter, Shore Supriya, Hyder Syed N, Kamdar Neil, Moles Victor M, Barnes Geoffrey D, Froehlich James, Mclaughlin Vallerie V, Paul Timir K, Rosenfield Kenneth, Giri Jay, Nallamothu Brahmajee K, Aggarwal Vikas
University of Michigan, Ann Arbor, Michigan.
University of Tennessee at Nashville, Ascension St. Thomas Hospital, Nashville, Tennessee.
Ann Am Thorac Soc. 2023 Nov;20(11):1571-1577. doi: 10.1513/AnnalsATS.202302-091OC.
Acute pulmonary embolism is a leading cause of cardiovascular death. There are limited data on the national mortality trends from pulmonary embolism. Understanding these trends is crucial for addressing the mortality and associated disparities associated with pulmonary embolism. To analyze the national mortality trends related to acute pulmonary embolism and determine the overall age-adjusted mortality rate (AAMR) per 100,000 population for the study period and assess changes in AAMR among different sexes, races, and geographic locations. We conducted a retrospective cohort analysis using mortality data of individuals aged ⩾15 years with pulmonary embolism listed as the underlying cause of death in the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database from January 2006 to December 2019. These data are produced by the National Center for Health Statistics. A total of 109,992 pulmonary embolism-related deaths were noted in this dataset nationwide between 2006 and 2019. Of these, women constituted 60,113 (54.7%). The AAMR per 100,000 was not significantly changed, from 2.84 in 2006 to 2.81 in 2019 (average annual percentage change [AAPC], 0.2; 95% confidence interval [CI], -0.1 to 0.5; = 0.15). AAMR increased for men throughout the study period compared with women (AAPC, 0.7 for men; 95% CI, 0.3 to 1.2; = 0.004 vs. AAPC, -0.4 for women; 95% CI, -1.1 to 0.3; = 0.23, respectively). Similarly, AAMR for pulmonary embolism increased for Black compared with White individuals, from 5.18 to 5.26 (AAPC, 0.4; 95% CI, 0.0 to 0.7; = 0.05) and 2.82 to 2.86 (AAPC, 0.0; 95% CI, -0.6 to 0.6; = 0.99), respectively. Similarly, AAMR for pulmonary embolism was higher in rural areas than in micropolitan and large metropolitan areas during the study period (4.07 [95% CI, 4.02 to 4.12] vs. 3.24 [95% CI, 3.21 to 3.27] vs. 2.32 [95% CI, 2.30-2.34], respectively). Pulmonary embolism mortality remains high and unchanged over the past decade, and enduring sex, racial and socioeconomic disparities persist in pulmonary embolism. Targeted efforts to decrease pulmonary embolism mortality and address such disparities are needed.
急性肺栓塞是心血管死亡的主要原因。关于肺栓塞导致的全国死亡率趋势的数据有限。了解这些趋势对于解决与肺栓塞相关的死亡率及相关差异至关重要。为了分析与急性肺栓塞相关的全国死亡率趋势，确定研究期间每10万人口的总体年龄调整死亡率（AAMR），并评估不同性别、种族和地理位置的AAMR变化。我们进行了一项回顾性队列分析，使用了2006年1月至2019年12月疾病控制和预防中心广泛在线流行病学研究数据库中15岁及以上以肺栓塞为潜在死亡原因的个体的死亡率数据。这些数据由国家卫生统计中心提供。在该数据集中，2006年至2019年期间全国共记录了109,992例与肺栓塞相关的死亡。其中，女性占60,113例（54.7%）。每10万人的AAMR没有显著变化，从2006年的2.84降至2019年的2.81（平均年百分比变化[AAPC]，0.2；95%置信区间[CI]，-0.1至0.5；P = 0.15）。在整个研究期间，男性的AAMR高于女性（男性AAPC，0.7；95% CI，0.3至1.2；P = 0.004，而女性AAPC，-0.4；95% CI，-1.1至0.3；P = 0.23）。同样，与白人相比，黑人因肺栓塞的AAMR有所增加，分别从5.18升至5.26（AAPC，0.4；95% CI，0.0至0.7；P = 0.05）和从2.82升至2.86（AAPC，0.0；95% CI，-0.6至0.6；P = 0.99）。同样，在研究期间，农村地区因肺栓塞的AAMR高于微型都市和大型都市地区（分别为4.07 [95% CI，4.02至4.12]、3.24 [95% CI，3.21至-3.27]和2.32 [95% CI，2.30 - 2.34]）。肺栓塞死亡率在过去十年中仍然很高且没有变化，并且在肺栓塞方面，性别、种族和社会经济差异仍然存在。需要有针对性地努力降低肺栓塞死亡率并解决这些差异。
