Does the Incidence and Mortality of Pulmonary Thromboembolism Change Over the Years?

Abstract

OBJECTIVES:In the last 20 years, with the use of computed tomography (CT) angiography, the number of patients diagnosed with pulmonary thromboembolism (PTE) has increased. At the same time, data show that pulmonary embolism mortality has also reduced in this duration. MATERIAL AND METHODS:In this study, we analyzed records of patients with PTE (using ICD's) in the hospital automation system from 2001 to 2013. Data regarding age, sex, date of diagnosis, diagnosis of cancer, hemodynamic status, initial and maintenance treatment, hospital length of stay, and hospital mortality were recorded. Primary endpoints of the study were hospital length of stay and all-cause hospital mortality. RESULTS:The total number of patients included in the study was 1185. The median age was 61 years in 2001 and 71 years in 2013. The number of patients who were diagnosed using CT increased from 10% to 92.8%. Between 2001 and 2013, the number of patients diagnosed with PTE increased, and of all patients with PTE, 13.7% was diagnosed in 2009. The hospital length of stay of 13 days declined to 9 days. The use of a vena cava filter in 2007 was 1.1% and that in 2013 was 4.6%. Mortality rate was 15%, however hospital mortality did not significantly differ over the years but varied between 9.4% and 18.8%. Increased use of thrombolytics in patients with massive PTE has been observed over the years. Massive PTE ratio in 2006 was 8.5% and thrombolytic use was 5.8%, however in 2013, these ratios were 2.6%, 6% respectively (p=0.017). CONCLUSION:Finally, despite the increased number of patients diagnosed with PTE over the years, the mortality rate was not observed to have changed from 2001 to 2013. KEYWORDS:Pulmonary thromboembolism, heparin, thrombolytic, mortality, incidence INTRODUCTIONPulmonary thromboembolism (PTE) is an important public health concern that causes mortality and morbidity. Its non-specific symptoms and findings lead to difficulties in confirming its diagnosis. However, with the use of computed tomography (CT) angiography in recent years, an important step has been taken in the diagnosis of PTE. Moreover, improvements, such as the development of new anticoagulants and mechanical interventions, have occurred in the treatment of PTE. In parallel with all these improvements, data on the incidence and outcomes of the disease seems to be restricted.In a study conducted in USA the incidence of PTE was reported to increase from 23/100,000 to 65/100,000 [1]. On the other hand, in a study conducted in Canada, no significant change was observed in the incidence of PTE in the last decade [2]. A study was conducted on 60853 patients in Italy, and an increase was found in the incidence of PTE in the last 10 years [3]. In our study, the data of patients diagnosed with PTE between 2001 and 2013 were obtained from hospital recordings and were analyzed. MATERIAL AND METHODSIn our study, the records of patients diagnosed with PTE between 2001 and 2013 were obtained from the hospital's automations system (with the International Classification of Di...

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