Trends in mortality related to pulmonary embolism in the DACH countries: data from the WHO Mortality Database

Abstract

Funding Acknowledgements Type of funding sources: None. Background Little is known about the burden imposed by pulmonary embolism for Germany, Austria and Switzerland (DACH countries). Purpose We aimed to assess pulmonary embolism-related mortality and time trends for the DACH countries based on data from the WHO Mortality Database. Methods We analysed vital registration data from the WHO Mortality Database (2000–2016) covering subregions of the WHO European Region: Germany, Switzerland and Austria (DACH countries). Deaths were considered pulmonary embolism-related if International Classification of Disease-10 code for acute pulmonary embolism or any code for deep or superficial vein thrombosis was listed as the primary cause of death. Results Between 2000 and 2016, age-standardised annual pulmonary embolism-related mortality rates decreased linearly from 15.6 to 7.8 deaths per 1000 population. In the 5-year period between 2012 and 2016 an average of 9127 pulmonary embolism-related deaths occurred annually in the DACH countries with a population of 98 273 329. Interestingly, pulmonary embolism-related mortality rates were considerable higher among women aged 15-55 years compared to age-matched men. Between 2012 and 2016, Germany showed the highest age-adjusted mortality rate (9.2 to 10.8 per 100000 inhabitants) compared to Switzerland 4.9-5.3 per 100000 inhabitants) and Austria (5.2 to 6.0 per 100000 inhabitants). Moreover, this means that the age-adjusted mortality rate in Germany was higher than the West-European average. Conclusion The observed decreasing trends in pulmonary embolism-related mortality might reflect improved management of the disease including new treatment options as well as advances in imaging technologies. However, pulmonary embolism remains a substantial contributor to total mortality, especially among women aged 15–55 years. For this reason, campaigns to increase physician and public awareness are urgently required for further improvement of the management and treatment of this preventable thrombotic disorder, which still remains the leading preventable cause of death.

Epidemiology, Etiology, and Pathophysiology of Pulmonary Embolism

“…6 Hobohm et al analyzed PE-related mortality and time trends for the DACH countries (Germany, Austria, and Switzerland). 19 In the 15-year period between 2000 and 2015, annual PE-related mortality decreased linearly from 15.6 to 7.8 per 1,000 deaths. 19 The reported improved survival rates in PE over the past 20 years are likely, at least in part, to be the result of better adherence to guidelines, improved risk stratification, and enhanced treatment.…”

“…19 In the 15-year period between 2000 and 2015, annual PE-related mortality decreased linearly from 15.6 to 7.8 per 1,000 deaths. 19 The reported improved survival rates in PE over the past 20 years are likely, at least in part, to be the result of better adherence to guidelines, improved risk stratification, and enhanced treatment. There is also the consideration that the fall in PE mortality rates may, as noted earlier in our review, be a result of increasing detection of small segmental or subsegmental PEs that do not adversely affect survival.…”

Pulmonary Embolism and Pregnancy—Challenges in Diagnostic and Therapeutic Decisions in High-Risk Patients

“…Although an overall decreasing trend in PE-related mortality over the past two decades was observed in a recent analysis of vital registration data in Europe, more than 1% of all deaths in women aged 15-50 years are caused by PE (3,4). VTE occurs and complicates one of 500-3,000 pregnancies and acute PE is still one of the leading causes of maternal death, also in highincome countries with highly developed medical health services (5,6).…”