Pulmonary Embolism Incidence and Fatality Trends in Chinese Hospitals from 1997 to 2008: A Multicenter Registration Study

Abstract

BackgroundThere has not been sufficient evidence to support the Asians being less susceptible to pulmonary embolism (PE) than other ethnicities, because the prevalence of PE/deep venous thrombosis (DVT) in different racial and ethnic groups has not been carefully studied until recently except in Caucasians. To test the hypothesis that the Chinese population has a lower risk for PE, this study comprehensively assessed the hospital-based incidence and case fatality rates for PE during the 1997–2008 in China.MethodsA registration study of patients with suspected PE syndromes admitted to 60 level-3 hospitals involved in the National Cooperative Project for the Prevention and Treatment of Venous Thromboembolism (NCPPT) was conducted from January 1997 to December 2008. The only exclusion criterion was an age of less than 18 years. Helical computed tomography scan, ventilation-perfusion lung scintigraphy or pulmonary angiography was carried out before or after hospitalization. All images were reviewed and evaluated independently by two specialists.ResultsA total of 18,206 patients were confirmed with PE from 16,972,182 hospital admissions. The annual incidence was 0.1% (95% CI: 0.1% to 0.2%). The overall incidence of PE in male patients (0.2%, 95% CI: 0.1% to 0.3%) was higher than that in female patients (0.1% and 95% CI: 0.0% to 0.1%). An increasing incidence gradient for PE was noticed from Southern to Northern China. In addition, the case fatality rate was apparently decreasing: 25.1% (95% CI: 16.2% to 36.9%) in 1997 to 8.7% (95% CI: 3.5% to 15.8%) in 2008.ConclusionsOur findings suggest the relatively stable PE incidence and decreasing fatality trends in Chinese hospitals may be partially attributable to the implementation of the NCCPT and suggest the government should reevaluate the severity of PE so that health resources for the prevention, diagnosis and treatment of PE could be used to their fullest.

Trends in hospital admissions for pulmonary embolism in Spain from 2002 to 2011

“…Increasing age was associated with higher rates of incidence and mortality, a phenomenon that has been reported in previous studies [5,7,15]. Also, females had a markedly higher burden of pulmonary embolism incidence and mortality than males, even though males have an increased prevalence of some risk factors, such as cigarette smoking and cancer [27].…”

“…During recent years, pulmonary embolism mortality has also decreased in these countries [5,6]. Meanwhile, in other countries, such as China, the incidence of pulmonary embolism has remained relatively stable in recent years while the case fatality rate has declined over the same period [7]. International variation may have been partly due to different risk factors for pulmonary embolism or inconsistencies in the accuracy of diagnosis.…”

Concurrent pulmonary thrombosis with systemic embolism: a case report

“…With the progression of diagnostic tools and knowledge update of this disease, the incidence of PE is increasing recently in China (Wang, 2010;Yang et al, 2011). Patients with susceptible factors, such as postoperative, DVT, and long-term oral contraceptives, need to be alert to the complications of PE (Wang, 2012).…”

“…Diagnosis of PE is usually underestimated due to the limited diagnostic tools in the past. However, with state-of-the-art technologies, the recognition of PE is gradually increasing in modern China (Yang et al, 2011).…”

Epidemiology, Clinical Presentations and In-Hospital Mortality of Venous Thromboembolism at the Douala General Hospital: A Cross-Sectional Study in Cameroon, Sub-Saharan Africa

“…The yield for acute pulmonary embolism (PE) was 37.5% for suspected cases [9]. The pattern of the epidemiology of VTE in SSA is comparable to that reported in the Asian sub-continent [10]- [15]. Deep Vein Thrombosis (DVT) of the legs has been shown to be more frequent than PE.…”