First-time pulmonary embolism elevated mortality risk even in cancer-free patients without baseline comorbidities, with adjusted hazard ratios of 3.72 at one year and 1.54 beyond three years.
Does first-time pulmonary embolism increase long-term all-cause mortality in cancer-free patients compared to matched population controls?
First-time pulmonary embolism is associated with a significantly increased risk of long-term all-cause mortality, even in patients without baseline comorbidities.
Background: Pulmonary embolism (PE) is associated with high mortality and morbidity.However, data on the long-term mortality risk in cancer-free PE patients compared to the general population remains limited.Aim: To study long-term all-cause mortality (one year and longer) in cancer-free PE patients versus matched population controls, stratified by the presence or absence of comorbidities.To assess the impact of comorbidities on life expectancy and to identify predictors of long-term mortality.Methods: A nationwide Swedish register study including cancer-free patients diagnosed with a first-time PE from 2006 to 2023 and matched population controls.All-cause mortality was analyzed using Cox proportional hazard regression models, expressed as adjusted hazard ratios (aHRs).Results: A total of 49,596 PE cases (mean age 67.3 years, 52.1% women) and 196,039 matched controls were included.One-year mortality was higher in PE cases (7.5%) compared to controls (1.6%).Among the PE cases, 53.6% had no comorbidities at baseline.Yet, the excess mortality risk remained elevated: one-year aHR 3.72 (95% CI, 3.36 -4.12); beyond three years, aHR 1.54 (95% CI, 1.46 -1.63).During follow-up, 18.5% of cases developed ischemic heart disease, and 22.7% heart failure.Cases without baseline comorbidities reached the 75th percentile of the survival distribution 8.1 years later (95% CI, 7.09-9.10)compared to PE patients with one or more comorbidities.Predictors of long-term mortality included heart failure (aHR 1.97, 95% CI, 1.88-2.06)and liver disease (aHR 2.17, 95% CI 1.88-2.51)Conclusion: PE increased long-term mortality risk even in the absence of baseline comorbidities.However, a substantial proportion of cases developed important conditions during follow-up, particularly cardiovascular diseases.
Tavoly et al. (2026) studied this question. First-time pulmonary embolism elevated mortality risk even in cancer-free patients without baseline comorbidities, with adjusted hazard ratios of 3.72 at one year and 1.54 beyond three years.