Trends in pulmonary embolism-related deaths in Europe

  • Barco S & al.
  • Lancet Respir Med
  • 11 Oct 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.


  • This comprehensive analysis of data from the WHO Mortality Database shows that age-standardised pulmonary embolism (PE)-related mortality has been continuously declining in both sexes across all European subregions since 2000, possibly reflecting advances in prophylaxis and treatment.
  • Despite this trend, PE remains an important contributor to total mortality, especially among women aged 15–55 years.

Why this matters

  • Findings contribute to an extensive correction of past mortality estimates and strengthen the basis for cause of death estimation of venous thromboembolic disorders.
  • PE still represents a global problem. Therefore, continuing efforts are warranted to improve awareness and implement effective preventive and risk-adapted therapeutic measures.

Study design

  • Analysis of disease burden from PE and time trends assessed within the WHO European Region, covering a total population of >650 million, and a period of 16 years based on medically certified vital registration data from the WHO Mortality Database (2000-2015).
  • Deaths were considered related to PE if the International Classification of Disease-10 code for acute PE (I26) or any code for deep or superficial vein thrombosis was listed as the primary cause of death.
  • Funding: German Federal Ministry of Education and Research.

Key results

  • Between 2013 and 2015, the annual average number of PE-related mortality in the 3-year period was 38,929 in the 41-member states with the population amounting to an average of 650,950,921 individuals.
  • PE-related deaths accounted for 8-13 cases per 1000 deaths in women and 2-7 cases per 1000 deaths in men among individuals aged 15-55 years.
  • From 2000 to 2015, age-standardised annual PE-related mortality rate by locally estimated scatterplot smoothing decreased from 12.8 (95% CI, 11.4-14.2) to 6.5 (95% CI, 5.3-7.7) deaths per 100,000 population.
  • From 2000 to 2015, the Joinpoint regression analysis showed a linear decrease in age-standardised PE-related mortality (annual change, –0.48 deaths per 100,000 population; 95% CI, –0.52 to –0.43), which was consistent between sexes.


  • Possibility of underestimating mortality related to PE cannot be excluded.