Trends and Disparities in Pulmonary Embolism Mortality in the United States, 1999– 2023

Background: Pulmonary embolism (PE) is a potentially life-threatening condition associated with significant morbidity, and mortality in adults aged 25 to 85 + years. We assessed trends in PE related mortality in the United States from 1999 to 2023 among adults to determine differences by gender, age, race/ethnicity, and geographic location using CDC WONDER data. Methods: We analyzed adults aged 25 to 85 + years death certificates from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC-WONDER) database with PE (ICD-10 codes: I26 and I26.9) from 1999–2023. Age-adjusted mortality rates (AAMR) per 1,000,000 population were stratified by gender, age, race, and geographic location. Join-point regression analysis was conducted to estimate the average annual percent changes (AAPC) with corresponding 95% confidence intervals (CI). Results: Between 1999 and 2023, mortalities due to PE caused 822482 deaths primarily in Medical Facility-Inpatient (432910) and Decedent's home (141478) deaths in adults aged 25 to 85 + years. The AAMR showed slight variations from 1999 to 2018 (APC: -0.176, 95% confidence interval (CI): -0.348 to − 0.004), increased sharply from 2018 to 2021 (APC: 15.39; 95% CI: 9.82–21.24) and finally decreased thereafter till 2023 (APC: -9.75; 95% CI: -13.79 to − 5.52). Additionally, the AAMR for males was higher than that of females. Non-Hispanic (NH) Blacks or African Americans displayed the highest AAMR, followed by NH Whites, and Hispanic or Latino. Midwest region showed highest AAMR, followed by South, Northeast, and West. District of Columbia was in the top 90th percentile. Rural areas exhibited higher AAMR than urban areas. Older adults had higher CMR than younger adults. Conclusion: PE-related mortality has risen significantly in recent years, with notable disparities across gender, race, and geographic regions. These findings highlight the urgent need for tailored public health strategies to mitigate the evolving burden of PE and promote equitable healthcare outcomes.