Pulmonary Embolism Support Group

By far the most common form of pulmonary embolism is a thromboembolism, which occurs when a blood clot, generally a venous thrombus, becomes dislodged from its site of formation and embolizes to the arterial blood supply of one of the lungs. Symptoms may include difficulty breathing, pain during breathing, and more rarely circulatory instability and death.

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Daffnae 09/04/2014

I saw some people sharing information on strokes today on Facebook. This made me start thinking about awareness of strokes versus PE. I decided to compare the number of deaths per year for each, and this is where I got a little confused.

From DVT / PE section on the CDC web site: "Estimates suggest that 60,000-100,000 Americans die of DVT/PE (also called venous thromboembolism)."

From the Stroke section on the CDC web site: "Stroke kills almost 130,000 Americans each year".

There was a link on the strokes page that had a PDF listing the top causes of death. I don't see Pulmonary Embolism listed in the top 15, and items 9 - 15 all have counts less than 60,000.

So, I'm wondering if PE is lumped in with one of the categories in the top 8 or if it is just in the big "other" category after the top 15. I'm really just curious, so if you happen to know the answer, please share.

Here are the top causes of death (I think I copied these from 2011 listing)

1 Diseases of heart
2 Malignant neoplasms
3 Chronic lower respiratory diseases
4 Cerebrovascular diseases
5 Accidents (unintentional injuries)
6 Alzheimers disease
7 Diabetes mellitus
8 Influenza and pneumonia
9 Nephritis, nephrotic syndrome and nephrosis
10 Intentional self-harm (suicide)
11 Septicemia
12 Chronic liver disease and cirrhosis
13 Essential hypertension and hypertensive renal disease
14 Parkinsons disease
15 Pneumonitis due to solids and liquids
All other causes

JuliesLife 09/04/2014

I suspect the fact that PE is only estimated is the issue. They can't rank those cases which are merely estimates. My guess is that strokes are far more obvious and easy to identify as a cause of death since they cause very unique symptoms (one sided weakness/paralysis, etc.) as opposed to PEs which cause very vague symptoms such as shortness of breath so strokes are more easily identifiable as a cause. The only way to confirm a PE post-mortem is with an autopsy and many people never have one. Instead the cause of death is just generically categorized based on circumstances. That's my complete guess, I have no hard facts behind it.

More2be 09/05/2014

The CDC indicates it has no precise grip on how many die of PE each year. Their estimate is 60,000 to 100,000. I have heard various percentages of how often PE is found to be the cause of death as indicated by autopsy. 10% is common, with one India-based study indicating that PE was found in 15% of autopsies, and a significant cause of death in 12%.
http://www.ncbi.nlm.nih.gov/pubmed/18160596
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1292084/
PE often is associated with cancer and other causes of death, leading PE statistics to be fragmented across other causes of death.
http://www.stoptheclot.org/news/article153.htm
The 2008 Surgeon General's Call to Action to Prevent DVT and PE went a long way toward digging up historically missing data by which PE was incorrectly omitted as a cause of death.
http://www.ncbi.nlm.nih.gov/books/NBK44181/
Basically, the reason you are not finding reliable statistics is that there are none.

RetiredNavy02 09/08/2014

Part of the problem is the way incidences of DVT/PE are reported nationally and even locally. In Virginia, as an example, incidence of VTE (DVT/PE) are reported under heart condition deaths. Another problem is often deaths caused by PE are lumped under another primary condition for which the patient is being seen. For example patient who dies while being treated for cancer. Dr. John Heit of the Mayo Clinic had conducted the closest to accurate surveillance of VTE to date (even though the numbers may be slightly off). His study showed that some of the patients who died during cancer treatment had actually suffered a PE during the course of their treatment.

(http://abstracts.hematologylibrary.org/cgi/content/abstract/106/11/910?maxtoshow=)

The study did accuratley show that: "VTE-related deaths were estimated at 296,370 annually. Of these deaths, 21,223 (7%) patients were diagnosed with VTE and treated, 101,032 (34%) were sudden fatal PE and 174,115 (59%) followed undetected PE. Approximately two-thirds of symptomatic VTE events were hospital-acquired and one-third were community-acquired"

The surveillance measures have been a long standing issue, something that the National Blood Clot Alliance and CDC both acknowledge. It is believed that the statistics may actually place death due to VTE as being #3 following heart disease and cancer (http://www.stoptheclot.org/news/article151.htm)

R/
Tom

Daffnae 09/09/2014

Thank you for the information. This was very helpful.

deleted_user 09/10/2014

Technically, any thromboembolic event is classified as "cardiopulmonary vascular disease", whether it causes a heart attack, a PE, a DVT or an ischemic stroke. The media often just calls the category of cardiopulmonary vascular disease "heart disease", which is totally inaccurate, but comes from a perceived need for simplification for the public. If we broke out what the press calls "heart disease" into smaller categories, we would find myocardial infarction, ischemic heart disease, congestive heart failure, rheumatic heart disease and cardiomyopathy, just to name a few along with PE/DVT and vasculitis and arteriovascular malformation and...well, you get the picture. PE is a statistical victim of "lumping" in graphics like this.

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