title: Pulmonary Embolism Mortality in Brazil from 1989 to 2010: Gender and Regional Disparities.
abstract: BACKGROUND
  A significant variation in pulmonary embolism (PE) mortality trends have been documented around the world. We investigated the trends in mortality rate from PE in Brazil over a period of 21 years and its regional and gender differences.
  
  
  METHODS
  Using a nationwide database of death certificate information we searched for all cases with PE as the underlying cause of death between 1989 and 2010. Population data were obtained from the Brazilian Institute of Geography and Statistics (IBGE). We calculated age-, gender- and region-specific mortality rates for each year, using the 2000 Brazilian population for direct standardization.
  
  
  RESULTS
  Over 21 years the age-standardized mortality rate (ASMR) fell 31% from 3.04/100,000 to 2.09/100,000. In every year between 1989 and 2010, the ASMR was higher in women than in men, but both showed a significant declining trend, from 3.10/100,000 to 2.36/100,000 and from 2.94/100,000 to 1.80/100,000, respectively. Although all country regions showed a decline in their ASMR, the largest fall in death rates was concentrated in the highest income regions of the South and Southeast Brazil. The North and Northeast regions, the lowest income areas, showed a less marked fall in death rates and no distinct change in the PE mortality rate in women.
  
  
  CONCLUSIONS
  Our study showed a reduction in the PE mortality rate over two decades in Brazil. However, significant variation in this trend was observed amongst the five country regions and between genders, pointing to possible disparities in health care access and quality in these groups.
authors.affiliation: Hospital Cárdio Pulmonar, Salvador, Salvador, Brazil.
authors.forename: Eduardo Sahade
authors.initials: ES
authors.lastname: Darze
authors.affiliation: Universidade Federal da Bahia, Salvador, BA, Brazil.
authors.forename: Juliana Borges
authors.initials: JB
authors.lastname: Casqueiro
authors.affiliation: Universidade Federal da Bahia, Salvador, BA, Brazil.
authors.forename: Luisa Allen
authors.initials: LA
authors.lastname: Ciuffo
authors.affiliation: Universidade Federal da Bahia, Salvador, BA, Brazil.
authors.forename: Jessica Mendes
authors.initials: JM
authors.lastname: Santos
authors.affiliation: Universidade Federal da Bahia, Salvador, BA, Brazil.
authors.forename: Iuri Resedá
authors.initials: IR
authors.lastname: Magalhães
authors.affiliation: Universidade Federal da Bahia, Salvador, BA, Brazil.
authors.forename: Adriana Lopes
authors.initials: AL
authors.lastname: Latado
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D011655:Pulmonary Embolism / Q000401:mortality*; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D012959:Socioeconomic Factors; D013997:Time Factors; D055815:Young Adult