Open AccessGlobal reporting of pulmonary embolism–related deaths in the World Health Organization mortality database: Vital registration data from 123 countries
Author(s) -
Barco Stefano,
Valerio Luca,
Gallo Andrea,
Turatti Giacomo,
Mahmoudpour Seyed Hamidreza,
Ageno Walter,
Castellucci Lana A.,
CesarmanMaus Gabriela,
Ddungu Henry,
De Paula Erich Vinicius,
Dumantepe Mert,
Goldhaber Samuel Z.,
Guillermo Esposito Maria Cecilia,
Klok Frederikus A.,
Kucher Nils,
McLintock Claire,
Ní Áinle Fionnuala,
Simioni Paolo,
Spirk David,
Spyropoulos Alex C.,
Urano Tetsumei,
Zhai Zhenguo,
Hunt Beverley J.,
Konstantinides Stavros V.
Publication year - 2021
Publication title -
research and practice in thrombosis and haemostasis
Language(s) - English
Resource type - Journals
ISSN - 2475-0379
DOI - 10.1002/rth2.12520
Subject(s) - medicine , mortality rate , demography , population , pulmonary embolism , cause of death , age adjustment , global health , public health , database , environmental health , surgery , pathology , disease , sociology , computer science
Pulmonary embolism (PE) has not been accounted for as a cause of death contributing to cause‐specific mortality in global reports. Methods We analyzed global PE‐related mortality by focusing on the latest year available for each member state in the World Health Organization (WHO) mortality database, which provides age‐sex–specific aggregated mortality data transmitted by national authorities for each underlying cause of death. PE‐related deaths were defined by International Classification of Diseases, Tenth Revision codes for acute PE or nonfatal manifestations of venous thromboembolism (VTE). The 2001 WHO standard population served for standardization. Results We obtained data from 123 countries covering a total population of 2 602 561 422. Overall, 50 (40.6%) were European, 39 (31.7%) American, 13 (10.6%) Eastern Mediterranean, 13 (10.6%) Western Pacific, 3 (2.4%) Southeast Asian, and 2 (1.6%) African. Of 116 countries classifiable according to population income, 57 (49.1%) were high income, 42 (36.2%) upper‐middle income, 14 (12.1%) lower‐middle income, and 3 (2.6%) low income. A total of 18 726 382 deaths were recorded, of which 86 930 (0.46%) were attributed to PE. PE‐related mortality rate increased with age in most countries. The reporting of PE‐related deaths was heterogeneous, with an age‐standardized mortality rate ranging from 0 to 24 deaths per 100 000 population‐years. Income status only partially explained this heterogeneity. Conclusions Reporting of PE‐related mortality in official national vital registration was characterized by extreme heterogeneity across countries. These findings mandate enhanced efforts toward systematic and uniform coverage of PE‐related mortality and provides a case for full recognition of PE and VTE as a primary cause of death.