Race and Gender Disparities in Pulmonary Embolism Mortality Rates - European Medical Journal

Race and Gender Disparities in Pulmonary Embolism Mortality Rates

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MORTALITY rates due to pulmonary embolism (PE) are higher amongst Black and male patients than those in other demographics, according to a new study led by Mohamed Zghouzi, University of Michigan, Ann Arbor, USA. Acute PE is a leading cause of cardiovascular death; however, there are limited data about the mortality trends arising from PE, which are vital to understand when addressing associated mortality and disparities. 

A retrospective cohort analysis was carried out, in which 109,992 patients (54.7% female; 76.4% White) were assessed. Each of the patients, sourced from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database, was at least 15 years of age, and had died as a result of PE between 2006–2019. In 2019, the age-adjusted mortality rate for PE was 2.81 per 100,000 people, and in 2006 it was 2.84 per 100,000 people, with an average annual percentage change of 0.2 (95% confidence interval [CI]: -0.1–0.5).  

When the patients were divided based on sex, the results demonstrated that more male patients than female patients experienced PE-related death (2.92 per 100,000; 95% CI: 2.90–2.95 versus 2.82 per 100,000; 95% CI, 2.80–2.84), a trend which continued through the years. Additionally, age-adjusted mortality rates per 100,000 people between 2006–2019 were highest amongst Black individuals (5.26; 95% CI: 5.19–5.34) compared to White (2.91; 95% CI: 2.89–2.93) and Hispanic (1.2; 95% CI: 1.17–1.24) patients. Zghouzi and colleagues also noted an increase in mortality rate for Black patients between 2006–2019 (average annual percentage change: 0.4; 95% CI: 0.0-0.7), while the rates did not change for those in other ethnic groups. Furthermore, more patients from rural areas died of PE than those in metropolitan areas. 

The team concluded: “These disparities underscore the need for multifaceted, broad-based interventions, including increased funding for research focused on investigating the underlying causes.” Zghouzi emphasised the need for educational initiatives aimed at increasing the awareness of PE-related death, and programmes for improving PE outcomes for all patients, specifically targeting those amongst whom PE may be underdiagnosed. 

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