title: Time trends and case fatality rate of in-hospital treated pulmonary embolism during 11 years of observation in Northwestern Italy.
abstract: Pulmonary embolism (PE) is a common disorder with high mortality and morbidity rates. However, population-based information on its incidence and prognosis remains limited. We conducted a large epidemiology study collecting data on hospitalisation for PE (from 2002 to 2012) in a population of about 13 million people in Northwestern Italy. Patients were identified using the ICD-9-CM codes: 415.11, 415.19; gender and age specific incidence rate of PE during the study period were estimated using the resident population for each year of the study. Furthermore, time trends in the in-hospital PE-related mortality and case fatality rate were calculated. Results were adjusted for possible confounders. A total of 60,853 patients (mean age 72.8 years, ± 14.1, 59.6% females) with PE were included; the overall crude incidence rate for the entire study period was 55.4 and 40.6 events per year per 100,000 inhabitants for women and men, respectively (p <0.001). However, this difference was completely lost after standardisation for age. The incidence of PE significantly increased in both genders during the study period. In-hospital case fatality rate significantly decreased throughout the study period (p < 0.001) in women (from 15.6% to 10.2%) and in men (from 17.6% to 10.1%). The observed decrease of the in-hospital case-fatality throughout the study period remained significant also after adjustment for possible confounders. In conclusion, time trends over an 11-year period show an increasing incidence of PE, but a significant reduction in mortality during hospitalisation. Reduction in the case fatality rate remained significant after adjustment for these possible confounders.
authors.affiliation: Francesco Dentali, U. O. Medicina Interna, Ospedale di Circolo, Viale Borri 57, 21100 Varese, Italy, Tel.: +39 0332 278594, Fax: +39 0332 278229, E-mail: fdentali@libero.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Dentali
authors.forename: Walter
authors.initials: W
authors.lastname: Ageno
authors.forename: Fulvio
authors.initials: F
authors.lastname: Pomero
authors.forename: Luigi
authors.initials: L
authors.lastname: Fenoglio
authors.forename: Alessandro
authors.initials: A
authors.lastname: Squizzato
authors.forename: Matteo
authors.initials: M
authors.lastname: Bonzini
mesh_terms: D000368:Aged; D015897:Comorbidity; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality* / Q000628:therapy; D012044:Regression Analysis; D013997:Time Factors; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality* / Q000628:therapy
keywords: Venous thromboembolism; mortality; prognosis; pulmonary embolism