Trends in hospital admissions for pulmonary embolism in England: 1996/7 to 2005/6

Abstract

-Pulmonary embolism (PE) can be difficult to diagnose and manage. This paper examines recent national trends in admission rates and mortality for PE to help inform clinical practice. Admissions to NHS hospitals in England between 1 April 1996 and 31 March 2006 were studied. Trends in admission rates, the proportion of all admissions with PE as primary or secondary diagnosis and hospital mortality following PE identified. There were 251,449 admissions with a diagnosis of pulmonary embolus in the study period. Non-elective admission rates rose from 28.0 per 100,000 in 1996/7 to 32.1 per 100,000 in 2005/6. There was a significant increase in secondary diagnosis rates and a clear seasonal pattern with excess admissions in winter. There was significant in-hospital mortality for both primary (13%) and secondary diagnosis (31%). Mortality decreased over time and was highest among the elderly. Pulmonary embolism is associated with a significant mortality although overall trends in mortality are improving in England. Age and comorbidities must be considered when developing guidelines and individual treatment plans.

Trends in hospital admissions for pulmonary embolism in Spain from 2002 to 2011

“…Hospital admissions rates for pulmonary embolism have also increased in the USA [15] and Denmark [16], as well as in other countries, such as those mentioned previously [3][4][5]. In contrast, we found a decrease in pulmonary Data are presented as n (hospitalisation rate per 100 000 inhabitants), unless otherwise stated.…”

“…Increasing age was associated with higher rates of incidence and mortality, a phenomenon that has been reported in previous studies [5,7,15]. Also, females had a markedly higher burden of pulmonary embolism incidence and mortality than males, even though males have an increased prevalence of some risk factors, such as cigarette smoking and cancer [27].…”

“…Hospital admission rates for pulmonary embolism have also increased over time in the UK [5] and Australia [6]. During recent years, pulmonary embolism mortality has also decreased in these countries [5,6]. Meanwhile, in other countries, such as China, the incidence of pulmonary embolism has remained relatively stable in recent years while the case fatality rate has declined over the same period [7].…”

“…For instance, in the USA and Canada, the mortality rate increased from the 1960 s through to the early 1980 s, and then decreased until the late 1990 s [17][18][19][20]. After initially increasing [21], mortality rates in the UK steadily declined from the late 1970 s [22] and in the period between 1996 and 2006 [5]. Otherwise, in Germany, the in-hospital mortality rate ranged from 20.…”

“…WIENER et al [4] found an increased incidence, minimal changes in mortality and a substantially lower case fatality rate. Hospital admission rates for pulmonary embolism have also increased over time in the UK [5] and Australia [6]. During recent years, pulmonary embolism mortality has also decreased in these countries [5,6].…”