Abstract
Background
The incidence of pulmonary embolism has been increasing. It has been suggested that
this may reflect overdiagnosis due to widespread use of computed tomographic pulmonary
angiography. The purpose of the present investigation is to further evaluate whether
the increasing incidence of pulmonary embolism represents overdiagnosis.
Methods
This was a retrospective cohort study based on administrative data from the National
(Nationwide) Inpatient Sample 1999-2014. International Classification of Diseases,
Ninth Revision, Clinical Modification codes were used. The population of the United
States according to year was determined from the Centers for Disease Control and Prevention.
Results
The incidence of pulmonary embolism increased from 65/100,000 population in 1999 to
137/100,000 population in 2014 (P < .0001). High-risk pulmonary embolism increased from 2.2/100,000 population to 9.9/100,000
population (P < .0001). The incidence of primary pulmonary embolism increased from 40/100,000 population
in 1999 to 73/100,000 population in 2014 (P < .0001). High-risk pulmonary embolism in patients with a primary diagnosis of pulmonary
embolism increased from 0.8/100,000 population in 1999 to 2.3/100,000 population in
2014 (P < .0001). Among patients with pulmonary embolism, the incidence of high-risk pulmonary
embolism increased from 1999-2014 (P = .0025). In-hospital all-cause mortality in high-risk patients was 102,402 of 195,909
(52.2%).
Conclusions
The incidence of high-risk pulmonary embolism has increased concordantly with the
increasing incidence of all pulmonary embolism. Increasing proportions of patients
with potentially lethal pulmonary embolism are being diagnosed.
Keywords
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Article Info
Publication History
Published online: November 24, 2020
Footnotes
Funding: None.
Conflict of Interest: None.
Authorship: All of the authors had access to the data and a role in writing the manuscript.
Identification
Copyright
© 2020 Published by Elsevier Inc.
