Pulmonary hypertension-related deaths in patients with acute pulmonary embolism in the United States, 2003 to 2020.

IF 3 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE Vascular Medicine Pub Date : 2024-10-01 Epub Date: 2024-08-07 DOI:10.1177/1358863X241257165
Marco Zuin, Roberto Badagliacca, Eileen Harder, Bridget McGonagle, Christie Greason, Gregory Piazza
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Abstract

Background: Data regarding the mortality trends in pulmonary embolism (PE)-related mortality in patients with concomitant pulmonary hypertension (PH) are lacking. We assessed the trends in PE-related mortality in patients with concomitant PH in the United States (US) over the past 2 decades and during the first year of the COVID-19 pandemic using data from the Centers for Disease Control and Prevention's (CDC) Wide-ranging ONline Data for Epidemiologic Research (WONDER) dataset.

Methods: Mortality data were retrieved from the publicly available CDC WONDER mortality dataset from 2003 to 2020. Age-adjusted mortality rates (AAMRs), per 100,000 population, were assessed using Joinpoint regression modelling and expressed as estimated average annual percentage change (AAPC) with relative 95% CIs and stratified by urbanicity, sex, age, and race/ethnicity.

Results: Over the study period, the AAMR for PE/PH-related mortality linearly increased (AAPC: +4.3% [95% CI: 3.7 to 4.9], p < 0.001) without sex differences. The AAMR increase was more pronounced in White individuals (AAPC: +4.8% [95% CI: 4.1 to 5.5], p < 0.001) and in subjects living in rural areas (AAPC: +5.1% [95% CI: 3.8 to 6.4], p < 0.001) compared to those living in urban areas. During the first year of the COVID-19 pandemic there was a significant excess in PE/PH-related mortality among women, older than 65 years and living in rural areas.

Conclusions: The rate of PE/PH-related mortality in the US is increasing. Although the early diagnosis of PH in patients with acute PE has become easier with improved diagnostic modalities, the mortality rate of these patients remains high.

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2003 至 2020 年美国急性肺栓塞患者中与肺动脉高压相关的死亡人数。
背景:有关合并肺动脉高压(PH)患者肺栓塞(PE)相关死亡率趋势的数据尚缺。我们利用美国疾病控制和预防中心(CDC)的广泛流行病学研究在线数据(WONDER)数据集的数据,评估了美国过去二十年以及 COVID-19 大流行第一年期间合并肺动脉高压的患者中与 PE 相关的死亡率趋势:从公开的疾病预防控制中心 WONDER 死亡率数据集中检索了 2003 年至 2020 年的死亡率数据。使用Joinpoint回归模型对每10万人口的年龄调整死亡率(AAMRs)进行评估,并以估计年均百分比变化(AAPC)和相对95% CIs表示,并按城市、性别、年龄和种族/民族进行分层:在研究期间,PE/PH 相关死亡率的 AAMR 呈线性增长(AAPC:+4.3% [95% CI:3.7 至 4.9],p < 0.001),无性别差异。与城市居民相比,白种人(AAPC:+4.8% [95% CI:4.1 至 5.5],p < 0.001)和农村居民(AAPC:+5.1% [95% CI:3.8 至 6.4],p < 0.001)的 AAMR 增加更为明显。在COVID-19大流行的第一年,65岁以上和居住在农村地区的女性PE/PH相关死亡率明显偏高:结论:美国 PE/PH 相关死亡率正在上升。尽管随着诊断方法的改进,急性 PE 患者 PH 的早期诊断变得更加容易,但这些患者的死亡率仍然很高。
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来源期刊
Vascular Medicine
Vascular Medicine 医学-外周血管病
CiteScore
5.70
自引率
5.70%
发文量
158
审稿时长
>12 weeks
期刊介绍: The premier, ISI-ranked journal of vascular medicine. Integrates the latest research in vascular biology with advancements for the practice of vascular medicine and vascular surgery. It features original research and reviews on vascular biology, epidemiology, diagnosis, medical treatment and interventions for vascular disease. A member of the Committee on Publication Ethics (COPE)
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