Mortality Trends of Hematological Malignancies and Those Complicated by Pulmonary Embolism: A Nationwide Population-Based Study

Objective The aim of this study was to analyze the mortality trends of hematological malignancies and those complicated by pulmonary embolism (PE) in the United States from 1999 to 2023. We also explores the mortality changes across multiple dimensions, including gender, age, region, urban-rural differences, and race. Methods Using death certificate data from the Centers for Disease Control’s Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database, we analyzed the age-adjusted mortality rates (AAMR) of hematological malignancies and hematological malignancies with PE among individuals aged 25 and above in the United States from 1999 to 2023. We assessed mortality trends across different genders, age groups, regions, urban-rural differences, and racial groups by calculating the average annual percentage change (AAPC) and annual percentage change (APC). Results From 1999 to 2023, the AAMR of hematological malignancies among individuals aged 25 and above in the United States showed a steady decline, with an AAPC of -1.75 (95% confidence interval (CI): -1.81 to -1.69), reflecting the positive achievements in the diagnosis, treatment, and management of hematological malignancies. However, the mortality rate of hematological malignancies with PE showed a distinctly different upward trend. The mortality rate increased with a low slope from 1999 to 2017 (APC 0.75, 95% CI 0.17–1.33), followed by a significant acceleration from 2017 to 2023 (APC 3.02, 95% CI 0.51–5.58), indicating a sharp increase in the mortality burden during these six years. Mortality rates for hematological malignancies with PE increased across gender, age, region, urban-rural differences, and race, particularly among males, the Western region, and individuals aged 75 and above. Higher mortality rates were also observed in non-metropolitan areas and among non-Hispanic Black individuals. Conclusion Despite a significant decline in the overall mortality rate of patients with hematological malignancies over the past 24 years, the mortality rate of patients with hematological malignancies complicated by PE has shown an upward trend, with significant differences across different genders, age groups, regions, urban-rural differences, and race. Future research and public health policies need to focus on these differences and develop targeted intervention strategies to reduce the mortality rate of PE in such patients and optimize prognosis.