Between 2003 and 2022, the incidence of acute pulmonary embolism in Switzerland increased from 0.87 to 1.19 per 1000 population, while mortality decreased from 18.7 to 13 per 100,000 population.
Observational (n=180,600)
Yes
A nationwide Swiss study over 20 years shows an increasing incidence of acute pulmonary embolism but decreasing mortality and in-hospital case fatality rates.
BACKGROUND: Data on the epidemiologic burden of acute pulmonary embolism (PE) in Switzerland are unavailable. Knowledge gaps remain on trends in PE-related comorbidities, PE severity, and length of in-hospital stay (LOS) at a nationwide level. OBJECTIVES: To study the epidemiology of acute PE with a focus on overall trends, sex-stratified trends, and trends in patients with (vs without) hemodynamic instability. METHODS: We used nationwide, patient-level data including all patients aged 15 years or older hospitalized for PE in Switzerland from 2003 to 2022, amounting to N = 180 600. Additionally, we analyzed the Swiss Death Registry for the same period. We estimated the disease-specific age-standardized incidence rates, mortality rates, in-hospital case fatality rates, proportional mortality rates, and LOS. Analyses were stratified by sex and the presence of features of high-risk PE. RESULTS: During the study period, the PE-related incidence rate increased from 0.87 (95% CI: 0.82, 0.92) per 1000 population in 2003 to 1.19 (95% CI: 1.15, 1.24) in 2022. In contrast, a decreasing trend was found for mortality rates (18.7 95% CI: 16.8, 20.6 per 100 000 population in 2003, 13 95% CI: 11.7,14.2 in 2022), in-hospital case fatality rate (9.8 95% CI: 9.1, 10.5 deaths per 100 hospitalized PE patients in 2003, 7.9 95% CI: 7.4, 8.5 in 2019, subsequent increase during COVID-19 pandemic), and LOS (11 Q1-Q3: 7-18 days in 2003, 8 Q1-Q3: 4-16 in 2022). No major sex differences in trends were present. Except for LOS reduction, patients with high-risk features presented with similar trends. CONCLUSION: The incidence of acute PE in Switzerland increased over the last 20 years. Despite increasing trends in the median age at PE diagnosis, in-hospital case fatality and mortality rates decreased, particularly among patients with high-risk features, and the LOS progressively declined.
Wolf et al. (Fri,) conducted a observational in Acute pulmonary embolism (n=180,600). Between 2003 and 2022, the incidence of acute pulmonary embolism in Switzerland increased from 0.87 to 1.19 per 1000 population, while mortality decreased from 18.7 to 13 per 100,000 population.