PB1466 - Early Mortality in Pulmonary Embolism – A Systematic Review and Analysis

Background: Acute pulmonary embolism (PE) is associated with 100,000 and 300,000 annual deaths in the United States and Europe respectively. Patients with a history of cancer, heart failure, chronic lung disease and of male sex are at a higher risk for adverse outcomes.

Aims: The aim of this study is to assess whether the highest risk patient populations are reflected in the randomized control trial data.

Methods: A systemic review of literature was performed, using PubMed and The Cochrane Library databases. The articles included met the following criteria: prospective, randomized controlled studies with more than100 acute PE patients and were published after the year 2000. Each article was reviewed by two different members of our team. Data on demographics and comorbidities associated with disease severity was extracted for further analysis.

Results: The literature search yielded 7473 articles. After duplicate removals and further screening, only 25 articles met our eligibility criteria (Figure 1).
Mortalities per comorbidity was seldom included in any of the studies, and thus, presenting percent mortality per comorbidity was not feasible. The weighted averages for the comorbidities associated with disease severity are presented in Table 1. The most reported characteristics were age, sex, hypertension, diabetes, heart failure, history of VTE and malignancy. Coronary artery disease was reported in 3/25 studies. The percent weighted averages were higher for males (46.7%), patients with hypertension (38%) and hyperlipidemia (43%). The weighted average for Caucasians was 70%; thus only 30% of the population included was non-white.

Conclusion(s): Percent mortality per comorbidity was not able to be determined due to seldom reporting. The percent weighted averages were higher for males, Caucasians and patients with hypertension and hyperlipidemia.