Acute pulmonary embolism was associated with a 35.5% all-cause mortality over a mean 3.8 years, with postdischarge mortality 2.5-fold higher than an age- and sex-matched general population.
Cohort (n=1,023)
No
What is the long-term cardiovascular and all-cause mortality in patients with confirmed acute pulmonary embolism?
Acute pulmonary embolism is associated with substantially increased long-term mortality, nearly half of which is cardiovascular, highlighting the need for long-term surveillance.
BACKGROUND: There are currently no guidelines advising long-term surveillance of patients following an acute pulmonary embolism (PE), because long-term outcome studies are rare. We investigated the long-term cardiovascular and all-cause mortality of a large patient cohort with confirmed PE in relation to baseline cardiovascular disease (CVD). METHODS AND RESULTS: Clinical details of all patients presenting with acute PE to a tertiary hospital were retrieved from medical records, and their survival tracked from a statewide death registry. There were 1023 (45% males) patients admitted with confirmed PE from 2000 to 2007. During a mean follow-up of 3.8±2.6 years, 363 patients died (35.5%), of whom only 31 (3.0%) died in-hospital during the index PE admission. The 3-month, 6-month, 1-year, 3-year, and 5-year cumulative mortality rates were 8.3%, 11.1%, 16.3%, 26.7%, and 31.6% respectively. Annual mortality did not improve over the 7-year period. The postdischarge mortality of 8.5%/patient-year was 2.5-fold that of an age- and sex-matched general population, being 12.6-fold in the youngest quintile (<55 years) and 1.9-fold in the oldest quintile (≥83 years). Patients with known CVD at baseline had 2.2-fold greater all-cause mortality than those without CVD, and this effect, although at a lower level of risk, remained significant after multivariate analysis. Of the 332 deaths occurring postdischarge, 40% were attributed to cardiovascular causes. CONCLUSIONS: In a contemporary adult population, PE is associated with a substantially increased long-term mortality, of which nearly half is cardiovascular. Our study highlights the urgent need to develop long-term surveillance strategies in this population.
Ng et al. (2010) conducted a cohort in Acute pulmonary embolism (n=1,023). Acute pulmonary embolism vs. Age- and sex-matched general population was evaluated on All-cause mortality. Acute pulmonary embolism was associated with a 35.5% all-cause mortality over a mean 3.8 years, with postdischarge mortality 2.5-fold higher than an age- and sex-matched general population.