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September 10, 2025Thrombosis and Haemostasis2 citationsOpen Access

Time trends in cause-specific mortality in patients with pulmonary embolism aged 50 years and older.

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KSKatarina Glise SandbladKSKristina SvennerholmJPJacob Philipson

Key Points

  • Cancer was the leading cause of 30-day mortality in PE patients aged ≥50 years, remaining stable from 2006 to 2023.
  • Mortality from fatal venous thromboembolism decreased significantly from 2.7% to 1.3%, indicating improved outcomes.
  • Cardiovascular disease-related mortality also declined from 2.3% to 1.1%, showing positive trends for older PE patients.
  • Subgroup analysis revealed a contrasting trend in cancer mortality between PE patients with and without known cancer.

Abstract

Patients with pulmonary embolism (PE) have high mortality rates. However, data on cause-specific mortality trends in this population are limited.To study time trends in cause-specific mortality among PE patients aged ≥50 years, analyzed across three time periods: 2006-2011, 2012-2017, and 2018-2023. The secondary aims included examining mortality trends in matched controls and subgroups of PE patients.This nationwide Swedish register study included patients with a first-time PE and matched controls. We assessed 30-day and 31- to 365-day cause-specific mortality and employed age- and sex-adjusted Poisson regression for the relative risk (RR) for annual mortality trends.The study comprised 115,476 patients, with cancer as the leading cause of 30-day mortality, stable at 4.7% from 2006-2011 to 2018-2023 (RR 1.00; 95% confidence interval CI: 0.99-1.01). Mortality from fatal venous thromboembolism (VTE) decreased from 2.7 to 1.3% (RR 0.94; 95% CI: 0.93-0.95), and cardiovascular disease from 2.3 to 1.1% (RR 0.94; 95% CI: 0.93-0.94). The 31- to 365-day mortality from cancer was stable at 11.8% in 2006-2011 and 11.4% in 2018-2022 (RR 1.00; 95% CI: 0.99-1.00), while mortality due to cardiovascular disease decreased from 4.1 to 2.3% (RR 0.96; CI: 0.95-0.96), and fatal VTE from 0.8 to 0.5% (RR 0.95; 95%: 0.93-0.96). Subgroup analysis showed a decrease in cancer-related mortality among PE patients with known cancer, while it increased in those without known cancer.Cancer was the leading cause of death in PE patients aged ≥50 years, with stable rates over time due to contrasting trends in patients with and without known cancer. Fatal VTE comprised a minor percentage of overall mortality in recent years.

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Cite This Study

Sandblad et al. (2025) studied this question.

synapsesocial.com/papers/68c1a3f954b1d3bfb60de1d1https://doi.org/10.1055/a-2668-5296
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