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<p>Pulmonary embolism (PE) remains a major cause of cardiovascular mortality in the United States. Despite therapeutic advances, emerging data suggest that national declines in PE mortality may have plateaued, with widening demographic and geographic disparities. To evaluate long-term trends and forecast future trajectories of PE mortality across sex, race, and state strata using national vital statistics. This population-level analysis used CDC WONDER multiple-cause-of-death data (1968–2023). Age-adjusted mortality rates (AAMRs) per 100,000 were calculated using the 2000 U.S. standard population. Joinpoint regression identified inflection points and Annual Percent Changes (APC). Forecasts through 2043 were generated with ARIMA(1, 1, 2) models. From 1968 to 2023, 516,187 PE deaths occurred nationwide. The AAMR declined from 9.92 (95%CI 9.71–10.13) to 3.31 (3.24–3.38), an overall − 1.84% annual reduction (<i>p</i> &lt; 0.000001). Joinpoint analysis revealed major inflections in 1974, 1979, 2004, and 2007, marking an early rise, prolonged fall, and post-2007 plateau. Men consistently had higher mortality (AAPC −2.19% vs. − 1.68% in women); Black individuals had roughly double the rates of White individuals (6.08 vs. 3.07 per 100,000 in 2024 projections). State-level mortality was highest in Mississippi (7.27) and lowest in California (1.56). Forecasts predict a slow decline to 2.40 per 100,000 by 2043 (− 26%), with persistent but narrowing race- and sex-based gaps. U.S. PE mortality has fallen markedly over five decades but has plateaued since 2007, with sustained inequities by race, sex, and geography. Continued progress will require equity-focused prevention, expanded outpatient thromboprophylaxis, and improved access to anticoagulation and diagnostic resources.</p> Graphical abstract <p></p>

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Pulmonary embolism mortality in the United States: a nationwide analysis

  • 期刊论文

  • 发表日期：

    2026年3月28日

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  • Ameer Awashra,
  • Anwar Zahran,
  • Mohammed AbuBaha,
  • Abubakar Nazir,
  • Mohammed Tareq Mutar,
  • Ahmed Emara,
  • Lubna Alnatour,
  • Mohamed S. Elgendy,
  • Abdalhakim Shubietah,
  • Mohammed Ruzieh,
  • Fadi Safi

摘要

Pulmonary embolism (PE) remains a major cause of cardiovascular mortality in the United States. Despite therapeutic advances, emerging data suggest that national declines in PE mortality may have plateaued, with widening demographic and geographic disparities. To evaluate long-term trends and forecast future trajectories of PE mortality across sex, race, and state strata using national vital statistics. This population-level analysis used CDC WONDER multiple-cause-of-death data (1968–2023). Age-adjusted mortality rates (AAMRs) per 100,000 were calculated using the 2000 U.S. standard population. Joinpoint regression identified inflection points and Annual Percent Changes (APC). Forecasts through 2043 were generated with ARIMA(1, 1, 2) models. From 1968 to 2023, 516,187 PE deaths occurred nationwide. The AAMR declined from 9.92 (95%CI 9.71–10.13) to 3.31 (3.24–3.38), an overall − 1.84% annual reduction (p < 0.000001). Joinpoint analysis revealed major inflections in 1974, 1979, 2004, and 2007, marking an early rise, prolonged fall, and post-2007 plateau. Men consistently had higher mortality (AAPC −2.19% vs. − 1.68% in women); Black individuals had roughly double the rates of White individuals (6.08 vs. 3.07 per 100,000 in 2024 projections). State-level mortality was highest in Mississippi (7.27) and lowest in California (1.56). Forecasts predict a slow decline to 2.40 per 100,000 by 2043 (− 26%), with persistent but narrowing race- and sex-based gaps. U.S. PE mortality has fallen markedly over five decades but has plateaued since 2007, with sustained inequities by race, sex, and geography. Continued progress will require equity-focused prevention, expanded outpatient thromboprophylaxis, and improved access to anticoagulation and diagnostic resources.

Graphical abstract