THROMBOLYTIC TREATMENT, THROMBECTOMY AND OUTCOMES OF ACUTE PULMONARY EMBOLISM - REAL-WORLD DATA FROM 2014 TO 2023 IN GERMANY
Author(s)
Lisa-Marie Müller, MSc1, Maximilian Nicolas Möbius-Winkler, Dr. med.2, Jonas Krampe, Dr. rer. nat1, Ulrich Laufs, Prof. Dr. med.2, Karsten Lenk, PD Dr. med.2, Alexander Kogel, Dr. med.2.
1Gesundheitsforen Leipzig GmbH, Leipzig, Germany, 2Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Leipzig, Germany.
1Gesundheitsforen Leipzig GmbH, Leipzig, Germany, 2Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Leipzig, Germany.
OBJECTIVES: To investigate recent trends in epidemiology, treatment patterns, and mortality outcomes of acute pulmonary embolism (PE) in Germany from 2014 to 2023, with a focus on risk stratification, comorbidity burden, and the utilization of reperfusion therapies.
METHODS: Retrospective analysis of health insurance claims data from the German Analysis Database for Evaluation and Health Services Research (DADB), comprising approximately 4 million insured individuals. Patients hospitalized with a diagnosis of PE (ICD-10-GM code: I26) between 2014 and 2023 were included. Risk stratification followed ESC guideline-based criteria using ICD and OPS codes for shock, cardiopulmonary resuscitation, and ICU treatment. Each PE hospitalization was matched 1:2 with controls by age, gender, and year. Comorbidities, treatment modalities, and mortality rates were analyzed using Fisher’s exact test, survival analysis and log-rank tests.
RESULTS: A total of 26,195 PE hospitalizations were identified. PE patients exhibited a significantly higher prevalence of risk factors and comorbidities, including cancer (35.5% vs. 15.1%), obesity, metabolic syndrome components, and cardiovascular diseases, compared to matched controls. Hospitalizations for PE increased from 2,054 in 2014 to 3,094 in 2023, while overall in-hospital mortality remained stable at approximately 12%. Mortality was highest in the high-risk group (57.4% in 2023) and lowest in the low/intermediate-low risk group (5.4% in 2023). One-year post-hospitalization mortality was markedly elevated in PE patients (27.5%) versus controls (4.0%), with risk-dependent mortality persisting up to ten years. Among high-risk patients, reperfusion therapy was underutilized (22.5%), and mortality was higher in treated versus untreated patients. Cancer diagnosis was associated with significantly reduced survival across all risk groups.
CONCLUSIONS: PE incidence in Germany increased over the past decade, with stable in-hospital mortality. Long-term mortality remains substantial, particularly in patients with cancer. Underutilization of reperfusion therapies in high-risk PE patients, especially the elderly, highlights the need for improved risk stratification and treatment optimization.
METHODS: Retrospective analysis of health insurance claims data from the German Analysis Database for Evaluation and Health Services Research (DADB), comprising approximately 4 million insured individuals. Patients hospitalized with a diagnosis of PE (ICD-10-GM code: I26) between 2014 and 2023 were included. Risk stratification followed ESC guideline-based criteria using ICD and OPS codes for shock, cardiopulmonary resuscitation, and ICU treatment. Each PE hospitalization was matched 1:2 with controls by age, gender, and year. Comorbidities, treatment modalities, and mortality rates were analyzed using Fisher’s exact test, survival analysis and log-rank tests.
RESULTS: A total of 26,195 PE hospitalizations were identified. PE patients exhibited a significantly higher prevalence of risk factors and comorbidities, including cancer (35.5% vs. 15.1%), obesity, metabolic syndrome components, and cardiovascular diseases, compared to matched controls. Hospitalizations for PE increased from 2,054 in 2014 to 3,094 in 2023, while overall in-hospital mortality remained stable at approximately 12%. Mortality was highest in the high-risk group (57.4% in 2023) and lowest in the low/intermediate-low risk group (5.4% in 2023). One-year post-hospitalization mortality was markedly elevated in PE patients (27.5%) versus controls (4.0%), with risk-dependent mortality persisting up to ten years. Among high-risk patients, reperfusion therapy was underutilized (22.5%), and mortality was higher in treated versus untreated patients. Cancer diagnosis was associated with significantly reduced survival across all risk groups.
CONCLUSIONS: PE incidence in Germany increased over the past decade, with stable in-hospital mortality. Long-term mortality remains substantial, particularly in patients with cancer. Underutilization of reperfusion therapies in high-risk PE patients, especially the elderly, highlights the need for improved risk stratification and treatment optimization.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH54
Topic
Clinical Outcomes, Epidemiology & Public Health, Real World Data & Information Systems
Topic Subcategory
Public Health
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Oncology