Pulmonary embolism mortality trends in the European region-too good to be true?,The Lancet Respiratory Medicine

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Pulmonary embolism mortality trends in the European region-too good to be true?
The Lancet Respiratory Medicine ( IF 38.7 ) Pub Date : 2020-01-01 , DOI: 10.1016/s2213-2600(19)30448-5
Lara N Roberts ₁ , Martin B Whyte ₂ , Roopen Arya ₁

Affiliation

We commend Stefano Barco and colleagues on their landmark paper quantifying age-standardised pulmonary embolism mortality rates and trends in Europe. However, we caution that the findings might be overly optimistic. In England, deaths from venous thromboembolism within 90 days of a hospital admission were introduced as a quality indicator within the National Health Service (NHS) Outcomes Framework in 2015.^, Although the key data published relate to venous thromboembolism deaths associated with hospitalisation, raw data for number of deaths from venous thromboembolism as recorded in the first part of the death certificate are available from 2007 to 2018. We summarise these data to enable comparison. Over the 3-year period of 2013–15, the average number of deaths from venous thromboembolism in England was 12 640 per annum. Using the raw NHS Outcomes Framework data and population statistics for England in 2018, we calculate a crude annual venous thromboembolism mortality rate of 21·7 (95% CI 21·0–22·4) per 100 000.^, By contrast, Barco and colleagues report the crude annual pulmonary embolism mortality rate for the UK as 8·3 (8·1–8·5) per 100 000. Of note, the NHS Outcomes Framework data are limited to adults and are not presented as an age-standardised rate. However, our calculated crude rate remains higher than the reported age-standardised rate of 8·9–13·3 over the same time period (2007–15) in the UK. Although Barco and colleagues' estimate of disease burden from pulmonary embolism deaths might be low, the concluding message is clear—pulmonary embolism remains a clinically significant cause of mortality for which both increased awareness and preventative action are required.

中文翻译：

欧洲地区的肺栓塞死亡率趋势-太好了吗？

我们赞扬Stefano Barco及其同事在具有里程碑意义的论文中量化了欧洲年龄标准化的肺栓塞死亡率和趋势。但是，我们告诫研究结果可能过于乐观。在英格兰，自2015年起在医院住院90天内因静脉血栓栓塞导致的死亡被作为一项质量指标引入了美国国家卫生服务（NHS）结果框架。2015年^，尽管已发布的关键数据与住院相关的静脉血栓栓塞死亡相关信息，但死亡证书第一部分中记录的静脉血栓栓塞死亡人数的原始数据可在2007年至2018年获得。我们对这些数据进行汇总以进行比较。在2013-15的3年期间，英格兰每年因静脉血栓栓塞致死的平均人数为12 640。在2018年使用英国的原始NHS成果架构数据和人口统计数据，我们计算每100 000一年度静脉血栓栓塞死亡率粗的21·7（95％CI 21·0-22·4） ^，相比之下，Barco及其同事报告的英国粗略的年度肺栓塞死亡率为每10万人8·3（8·1-8·5）。值得注意的是，NHS成果框架数据仅限于成年人，未提供作为年龄标准化的比率。但是，我们计算出的原油价格仍然高于英国同期（2007-15年）所报告的年龄标准的8·9-13·3。尽管Barco及其同事对因肺栓塞致死的疾病负担的估计可能很低，但结论很明确-肺栓塞仍然是临床上重要的死亡原因，对此既要提高认识，又需要采取预防措施。

更新日期：2019-12-20

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