Mortality Trends in Patients With High-Risk Pulmonary Embolism

Although the mortality of patients with high-risk pulmonary embolism (PE) has decreased over time, the decrease cannot be attributed to improved treatments for PE, according to the results of a recent study published in The American Journal of Medicine.

Researchers tracked the mortality rates of patients diagnosed with high-risk PE over the last 19 years in the United States. These trends in mortality were assessed according to advances in treatment over the same period. Patients were defined as high risk if they experienced shock or cardiac arrest.

From 1999 to 2017, there were 58,784 patients in United States with a primary diagnosis of PE that was defined as high-risk. Mortality in 1999 was 72.7%, decreasing to 49.8% in 2017 (P <.0001). Most patients (60.3%) were treated with anticoagulants alone. Mortality in these patients decreased from 79.0% in 1999 to 55.7% in 2017 (P <.0001). The researchers noted that mortality decreased even though the patients did not receive advanced therapy for PE; therefore, the decreasing mortality cannot be attributed to the use of inferior vena cava filters. Mortality decreased with anticoagulants alone and no inferior vena cava filter. In addition, thrombolytic therapy was associated with lower mortality than anticoagulants alone, but only a few patients received it.

“By process of elimination, the decreasing mortality in high-risk patients with pulmonary embolism reflects advances in management of shock and management of cardiac arrest,” the study authors wrote.

Reference

Stein PD, Matta F, Hughes PG, Hughes MJ. 19-Year trends in mortality of patients hospitalized in the United States with high-risk pulmonary embolism. Am J Med. Published online February 22, 2021. doi:10.1016/j.amjmed.2021.01.026