Time trends in cause-specific mortality in patients with pulmonary embolism aged 50 years and older.
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Background Patients with pulmonary embolism (PE) have high mortality rates, particularly patients 50 years of age. However, data on trends in cause-specific mortality in this population are limited. Aims To study time trends in cause-specific mortality among PE patients aged 50 years from 2006 to 2023, analyzed across four periods: 2006-2012, 2013-2019, 2020-2021, and 2022-2023. The secondary aim was to study all-cause mortality trends. Methods This nationwide Swedish register study included patients with a first-time PE. We assessed 30-day and 31-365-day cause-specific mortality using data from the National Cause of Death Register and employed age- and sex-adjusted Poisson regression to determine the relative risk (RR) for annual mortality trends. Results The study comprised 115,476 patients, with cancer as the leading cause of 30-day mortality, stable at 4.7% in 2006-2012 to 5% in 2022-2023; RR 1.00 (95% confidence interval, CI: 0.99-1.01). Mortality from fatal venous thromboembolism (VTE) decreased from 2.6% to 1.3%; 0.94 (0.93-0.95), and cardiovascular disease from 2.3% to 1.0%; 0.94 (0.93-0.94). The 31 to 365-day mortality from cancer was stable, 12.0% in 2006-2012 and 11.9% in 2022; RR 1.00 (95% CI: 0.99-1.00), while mortality due to cardiovascular disease decreased from 4.1% to 2.3%; 0.96 (0.95-0.96), and fatal VTE; 0.8% to 0.3%; 0.95 (0.93-0.96). Conclusions Cancer was the leading cause of death for both 30-day and 31-365-day mortality in PE patients aged ≥50 years, remaining stable over time, while fatal VTE and cardiovascular disease mortality declined. Fatal VTE comprised a minor percentage of overall mortality in recent years.
