Objectives

Up-to-date population-based data on pulmonary embolism (PE)-related sudden cardiac death (SCD) mortality trends in the United States (US) are scant. We assess the current trends in PE-related SCD mortality in US over the past two decades and determine differences by sex, race, ethnicity, age, and census region.

Methods

We extracted PE-related SCD mortality rates from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database from 1999 to 2019, in patients aged ≥ 15 years old. Age‐adjusted mortality rates (AAMRs) were assessed using the Joinpoint regression modeling and expressed as estimated average annual percentage change (AAPC) with relative 95% confidence intervals (CIs).

Results

Between 1999 and 2019, the AAMR from acute PE-related SCD mortality in the US linearly increased [AAPC: +2.4% (95% CI: 2.2 to 2.6), p < 0.001)]. The AAMR increase was more pronounced in men [AAPC: +2.8% (95% CI: 2.6 to 2.9), p < 0.001], Whites [AAPC: +2.7% (95% CI: 2.3 to 3.1), p < 0.001], Latinx/Hispanic patients [AAPC:+2.0% (95% CI: 1.2 to 2.8), p < 0.001], subjects younger than 65 years [AAPC: +2.4% (95% CI: 2.1 to 2.6), p < 0.001] and in residents of rural areas [AAPC: +3.6% (95% CI: 3.3 to 3.9), p < 0.001]. Moreover, higher percentages of PE-related SCD and the relative absolute number of deaths were observed in the South compared with other geographical regions.

Conclusions

PE-related SCD mortality in the US has increased over the last two decades. Stratification by race, ethnicity, urbanization, and census region demonstrates ethnoracial and regional disparities that require further investigation and remedy.

中文翻译：

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1999-2019 年美国肺栓塞相关心源性猝死的趋势

目标

美国 (US) 肺栓塞 (PE) 相关心源性猝死 (SCD) 死亡率趋势的最新人群数据很少。我们评估了过去二十年美国与 PE 相关的 SCD 死亡率的当前趋势，并确定了性别、种族、民族、年龄和人口普查地区的差异。

方法

我们从疾病控制和预防中心流行病学研究广泛在线数据 (CDC WONDER) 数据库中提取了 1999 年至 2019 年 15 岁以上患者中与 PE 相关的 SCD 死亡率。使用 Joinpoint 回归模型评估年龄调整死亡率 (AAMR)，并表示为具有相对 95% 置信区间 (CI) 的估计平均年百分比变化 (AAPC)。

结果

1999 年至 2019 年间，美国急性 PE 相关 SCD 死亡率的 AAMR 线性增加 [AAPC：+2.4%（95% CI：2.2 至 2.6），p  < 0.001）]。AAMR 增加在男性中更为明显 [AAPC：+2.8%（95% CI：2.6 至 2.9），p  < 0.001]，白人 [AAPC：+2.7%（95% CI：2.3 至 3.1），p  < 0.001] ，拉丁裔/西班牙裔患者 [AAPC：+2.0%（95% CI：1.2 至 2.8），p  < 0.001]，年龄小于 65 岁的受试者 [AAPC：+2.4%（95% CI：2.1 至 2.6），p  < 0.001 ] 和农村地区居民 [AAPC：+3.6%（95% CI：3.3 至 3.9），p  < 0.001]。此外，与其他地理区域相比，南方地区与 PE 相关的 SCD 的百分比和相对绝对死亡人数较高。

结论

过去二十年来，美国与 PE 相关的 SCD 死亡率有所增加。按种族、民族、城市化和人口普查地区进行的分层显示了民族和地区差异，需要进一步调查和补救。