Eikermann Greta Muriel, Tam Christopher, Eyth Annika, Ludeke Can Martin, Grimme Aline M, Ramishvili Tina, Borngaesser Felix, Rudolph Maira, Aber Nicole, Stoll Sandra Emily, Kyriacou Corinne M, Ganz-Lord Fran A, Karaye Ibraheem M
Ethical Culture Fieldston School, New York, NY, USA.
Department of Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210Th Street, Bronx, NY, USA.
J Racial Ethn Health Disparities. 2024 Oct 25. doi: 10.1007/s40615-024-02197-5.
While the National Institutes of Health emphasize integrating sex as a biological variable into research, specific considerations of sex-related differences in pulmonary embolism (PE) mortality trends remain scarce. This study examines sex-based PE mortality trends across regional and demographic groups in the USA from 1999 to 2020.
A retrospective analysis of National Center for Health Statistics mortality data from 1999 to 2020 was conducted. Using ICD-10 code I26, PE decedents were identified. Piecewise linear regression assessed sex-based temporal trends in PE mortality by age, race/ethnicity, and census region. Annual percentage changes and average annual percentage changes were derived using Weighted Bayesian Information Criteria. The 95% confidence intervals were estimated using the empirical quantile method.
From 1999 to 2020, a total of 179,273 individuals died in the USA due to PE, resulting in an age-adjusted mortality rate of 2.5 per 100,000 persons (95% CI, 2.5-2.5). While men and women exhibited comparable rates in recent time segments and across most subcategories, a higher mortality trend among males compared to females was observed among non-Hispanic White and Hispanic individuals and residents of the Western US census region. These results remained robust even after excluding data from 2020, accounting for the potential impact of the COVID-19 pandemic.
Our study highlights sex-based disparities in PE mortality trends in the USA from 1999 to 2020. Despite overall stable mortality rates, higher trends among males were evident in specific demographic groups and regions. These findings emphasize the importance of targeted interventions to mitigate PE-related mortality discrepancies across diverse populations.
虽然美国国立卫生研究院强调将性别作为一个生物学变量纳入研究，但关于肺栓塞（PE）死亡率趋势中性别相关差异的具体考量仍然很少。本研究调查了1999年至2020年美国各地区和人口群体基于性别的PE死亡率趋势。
对1999年至2020年美国国家卫生统计中心的死亡率数据进行回顾性分析。使用国际疾病分类第十版（ICD - 10）编码I26识别PE死亡者。分段线性回归按年龄、种族/族裔和人口普查区域评估基于性别的PE死亡率时间趋势。使用加权贝叶斯信息准则得出年度百分比变化和平均年度百分比变化。采用经验分位数法估计95%置信区间。
1999年至2020年，美国共有179,273人死于PE，年龄调整后的死亡率为每10万人2.5例（95%置信区间，2.5 - 2.5）。虽然男性和女性在最近时间段以及大多数子类别中的死亡率相当，但在非西班牙裔白人、西班牙裔个体以及美国西部人口普查区域的居民中，观察到男性的死亡率趋势高于女性。即使排除2020年的数据以考虑新冠疫情的潜在影响，这些结果仍然稳健。
我们的研究突出了1999年至2020年美国PE死亡率趋势中基于性别的差异。尽管总体死亡率稳定，但在特定人口群体和地区，男性的死亡率趋势更高。这些发现强调了针对性干预措施对于减轻不同人群中与PE相关的死亡率差异的重要性。
