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Geriatric Patients in the ICU

Research Snapshot Theater: Geriatric Patients in the ICU II

(436) Trends in High-Risk Pulmonary Embolism Mortality Among Elderly Individuals in the US From 1999-2020

Tuesday, February 25, 2025
10:00am – 11:00am Eastern Time
Location: Connections Central - RST 01

    First Author(s)

  • MS

    Mustafa Shehzad, MD

    Resident
    Department of internal Medicine Hackensack university medical center
    Hackensack, New Jersey, United States

    • Co-Author(s)

  • Dawlat Khan, MD

    Sanford USD Medical Center
    Sioux Falls, South Dakota, USA

  • MA

    Muhammad Ahmad, MBBS

    Medical Student
    Khyber Medical College Pakistan, Pakistan

  • HC

    Hammad Chaudhry, MD

    Hospitalist Internal Medicine
    Sanford USD Medical Center
    Sioux Falls, South Dakota, United States

  • DS

    Dawood Shehzad, MD

    Resident
    Department of internal Medicine University of South Dakota
    Sioux Falls, South Dakota, United States

Introduction: The increasing prevalence of VTE and utilization of chest computed tomography in the aging population have continued to drive up the overall incidence of PE in the US. Population-based data on high-risk pulmonary embolism (PE) mortality in older adults from the US is lacking

Methods: A retrospective analysis was conducted using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) dataset. High-risk PE was identified in patients with ICD-10 codes for PE and codes for cardiogenic shock or cardiac arrest listed as a contributing cause of death in the final death certificate. Age-adjusted mortality rates (AAMR), crude mortality rates, and annual percentage changes (APC) were calculated through Joinpoint regression for adults above the age of 65 years. The results were stratified to uncover the temporal, demographic, and geographic disparities in AAMRs

Results: Between 1999 and 2020, high-risk PE was listed as the underlying cause of death in 75,934 patients, corresponding to an overall Age-Adjusted Mortality Ratio (AAMR) of 8.24 per 100,000 people (95% CI 8.18–8.298). For both older males and females, AAMR remained relatively stable until 2007 and 2004, respectively. For Males from 2007 to 2020 [(Annual Percentage change) APC: 2.0%, 95% CI: 1.33–5.46]. For females from 2004 to 2020 [APC: 1.49%, 95% CI: 0.99–3.86]. The APC for White individuals from 2004 to 2020 was [2.1%, 95% CI: 1.76–3.00]. For Asian/Pacific Islanders from 2016 to 2020 [APC: 6.22%, 95% CI: 0.17–18.66]. For Black 2017 to 2020 [APC: 6.88%, 95% CI:1.45–14.21]. For Hispanic/Latino from 2018 to 2020 [APC: 21.56%, 95% CI: 1.46–32.25]. AAMR increased in all Census regions in the US from 1999-2020. Northeast (Average Annual Percentage change (AAPC) was 1.61%, 95% CI: 1.22–1.93, Midwest [AAPC: 2.28% 95% CI: 1.54–2.92], Southern [AAPC: 1.37%, 95% CI: 0.84–2.02] West [AAPC: 1.46% 95% CI: 0.91–1.85]. For all geriatric adults from 1999 to 2020, the annual increase was [AAPC 1.01%, 95% CI 0.66–1.55].

Conclusions: There is a concerning increase in the adjusted mortality from high-risk PE in the geriatric population in the US. Racial, Sex-based, and regional variations exist.