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

Race and Gender Disparities in Pulmonary Embolism Mortality Rates

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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