Epidemiology

The incidence of pulmonary embolism in the UK varies from 7-8 per 10,000 people, per year. (1) The incidence increases with age. The annual rate in people:

• under 40 years is around 1 in 10,000
• over 80 years can reach 1 in 100 (2)

In England, 35,845 hospital admissions for pulmonary embolism were reported in the 1-year period between 2022 and 2023. (3) The number of deaths due to PE was 7388 between 2019 and 2021. (4)

Between 2007 and 2009, PE resulted in 277,549 adult hospitalisations in the US. Of these patients, an average of 19,297 died each year (5)

If left untreated, the prognosis for PE is poor. In the International Cooperative Pulmonary Embolism Registry, the all-cause mortality rate at three months associated with acute PE was 17%. PE was considered to be the cause of death in 45% of patients (6)

However when diagnosed and treated early, mortality risk is low (about 1%) in most episodes of pulmonary embolism. Patients in the high-risk category have a short-term mortality of 10.9%, while patients in the low-risk category have 30-day mortality of 1%. (7)

Venous thromboembolism (VTE) remains one of the main direct causes of maternal death in the UK and sequential reports on Confidential Enquiries into Maternal Deaths have highlighted failures in obtaining objective diagnoses and employing adequate treatment (8)

References:

1. Rivaroxaban for treating pulmonary embolism and preventing recurrent venous thromboembolism. NICE Technology Appraisal Guidance, June 2013
2. Meyer G et al. Pulmonary embolism. BMJ. 2010;340:c1421
3. NHS England. Hospital admitted patient care activity, 2022-23. Sep 2023 [internet publication].
4. Office for National Statistics. Deaths in 2019, 2021, and 2022 due to blood clots. Jul 2022 [internet publication].
5. Centers for Disease Control and Prevention (CDC). Venous thromboembolism in adult hospitalizations - United States, 2007-2009. MMWR Morb Mortal Wkly Rep. 2012 Jun 8;61(22):401-4.
6. Goldhaber SZ et al. Pulmonary embolism and deep vein thrombosis. Lancet. 2012 May 12;379(9828):1835-46.
7. Zhou XY, Ben SQ, Chen HL, et al. The prognostic value of pulmonary embolism severity index in acute pulmonary embolism: a meta-analysis. Respir. Res. 2012 Dec 4;13:111.
8. RCOG (2015). Green-top Guideline No. 37b - Thromboembolic Disease in Pregnancy and the Puerperium: Acute Management