Epidemiology

The incidence of diagnosed pulmonary embolism 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 (1)

The real incidence is thought to be underestimated since autopsy studies reveal that PE is clinically suspected in less than half of fatal cases (1).

• more than doubled rates of hospital admission for pulmonary embolism in the past 10 years, although the case fatality rate has remained stable or decreased ((2)
• annual incidence of pulmonary embolism in the population is 1 per 1000 people, but this increases sharply with age, from 1.4 per 1000 people aged 40-49 to 11.3 per 1000 aged 80 years or over ((2)

UK:

• pulmonary embolism affects 1 per 1000 population per year (1,2)
• may contribute to 15-20% of all deaths in an acute general hospital (1)

USA:

• 650,000 asymptomatic cases annually
• pulmonary embolism is a contributory to cause of death in 200,000 cases annually
• sole cause of death in 50,000 cases annually

However when diagnosed and treated early, mortality risk is low (about 1%) in most episodes of pulmonary embolism (1).

Massive pulmonary embolism which is fatal in around 40% of patients, is responsible for only 5% of all cases of pulmonary embolism (1)

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 (4)

• there has been a significant decline in maternal deaths from VTE in the UK (18 deaths between 2006 and 2008 compared to 41 in 2003–2005), in part owing to better recognition of women at risk and more widespread use of thromboprophylaxis

Reference:

• (1) Meyer G et al. Pulmonary embolism. BMJ. 2010;340:c1421
• (2) Duffett L et al. Pulmonary embolism: update on management and controversies. BMJ 2020;370:m2177 http://dx.doi.org/10.1136/bmj.m2177
• (3) Robinson GV. Pulmonary embolism in hospital practice. BMJ. 2006;332(7534):156-60.
• (4) RCOG (2015). Green-top Guideline No. 37b - Thromboembolic Disease in Pregnancy and the Puerperium: Acute Management