Pulmonary embolism (PE) is a serious medical event caused by a blockage in the arteries of the lungs, typically by a blood clot that originated in a deep vein in the legs (deep vein thrombosis, or DVT). Understanding PE statistics illustrates the public health burden and highlights the urgency for rapid diagnosis and treatment. As a major cause of cardiovascular death, these statistics guide both clinical practice and public awareness campaigns.
Incidence and Prevalence
In the United States, the annual incidence of PE is estimated to be between 60 and 70 cases per 100,000 people. This rate translates to approximately 650,000 new cases diagnosed each year across the country.
The true incidence is likely higher than clinical data suggests, as many cases of PE go undiagnosed. Autopsy studies have shown that PE was the cause of death in about 11% of sudden deaths, often without prior clinical diagnosis. Furthermore, silent PEs are common, found in 40% to 50% of patients who have DVT but no PE symptoms. These figures emphasize that the officially reported rates are a minimum estimate of the total disease burden.
Mortality and Survival Rates
The fatality associated with pulmonary embolism varies based on the promptness of diagnosis and the severity of the event. Untreated PE carries a mortality rate as high as 30%, which drops to around 8% when the condition is recognized and treated effectively. The most severe form, acute massive PE, may result in sudden death, which occurs in about 10% of acute PE cases.
Most deaths from PE happen rapidly; two out of every three patients who succumb die within two hours of presentation. For patients who survive the initial event, the 30-day mortality risk is stratified by severity. Low-risk patients face a 1% to 6% chance of death within 30 days, while high-risk patients may have a 30-day mortality rate ranging from 10% to nearly 25%.
Between 1999 and 2008, age-adjusted mortality rates showed a reduction, reflecting improvements in detection and care. However, this positive trend reversed after 2008, with mortality rates subsequently increasing by an average of 0.6% annually through 2018. This stabilization of the death rate, despite advances in care, suggests that challenges in early diagnosis and patient management persist.
Demographic and Risk Factor Distribution
The incidence of PE increases sharply with age, with the majority of cases occurring in individuals aged 60 years and older. While the median age at death from PE has recently decreased slightly, older adults consistently represent the highest absolute number of PE-related deaths.
Significant disparities exist in PE-related mortality across racial and ethnic groups. Black individuals consistently experience age-adjusted mortality rates that are up to twofold higher compared to White individuals. This persistent gap highlights the need to address underlying socioeconomic and healthcare access factors that contribute to these unequal outcomes.
Several predisposing factors increase the risk of developing PE. Hospitalized patients are at an elevated risk, with VTE being responsible for up to 10% of deaths among patients admitted to the hospital. Cancer patients face a particularly high risk, as approximately one in five VTE cases overall are related to cancer or its treatment. Other major factors include recent surgery, inherited clotting disorders, and prolonged immobility.
Recurrence and Long-Term Outcomes
The risk of a second event and the development of chronic conditions remain concerns for patients who survive the acute episode. The cumulative risk of experiencing a recurrent VTE event is approximately 8% within the first year after the initial episode. This risk nearly triples over the longer term, with recurrence rates rising to about 22% within five years.
A major complication for survivors is Chronic Thromboembolic Pulmonary Hypertension (CTEPH). CTEPH occurs when blood clot scar tissue fails to dissolve completely, leading to chronic obstruction and high blood pressure in the lung arteries. While the incidence of CTEPH in all PE patients is low, ranging from 0.56% to 1.5%, the cumulative incidence among PE survivors is estimated to be around 3%.
Beyond recurrence and CTEPH, survivors experience a lasting reduction in quality of life. About one-third of individuals who recover from PE develop a condition known as post-PE syndrome. This syndrome is characterized by long-term functional limitations and persistent shortness of breath, which can continue for three months or more after the initial event.