OBJECTIVES: Pulmonary embolism (PE) is likely associated with a substantial economic burden to society, however, respective evidence in Europe is scarce. The aim of this study was to report healthcare resource utilization (HCRU) and absence from work of PE patients using the PREFER in VTE registry.

METHODS: The PREFER in VTE registry was a prospective, observational, multicenter study in seven European countries, providing data concerning treatment patterns, HCRU, mortality and quality of life. Data was available for 1,399 patients with a first-time and/or recurrent PE with follow up documentation at 1, 3, 6 and 12 months. Descriptive statistics were presented by cancer and country subgroups. Logit and Cox regression was implemented to investigate the relationship between baseline characteristics and hospitalization and return to work, respectively.

RESULTS: Average age was 62.3 years old. Cancer patients were mostly treated with heparin (84.9%), while non-cancer patients were treated with combinations of heparin, VKA and NOACs. NOACs were used less in Italy and Spain (4.5% and 6.1 %). VTE-related re-hospitalization rate and average length of stay at 12 months varied substantially between countries, from 26.2% in UK to 12.3% in France, and from 12.9 days in Italy to 3.9 days in France, respectively. PE patients were often co-managed by general practitioners in France and DACH (Germany, Austria and Switzerland) (>84%), whereas the number was lower in other countries (<47%). The regression results confirmed the country variation of HCRU. Of working subjects, 60% returned to work at 1 month but more than 30% had not returned after one year. Cancer was a significant predictor for not returning to work.

CONCLUSIONS: Medical treatment of PE differs between cancer and non-cancer patients. VTE related resource utilization differs markedly between countries. Work-loss seems high in patients with PE, but may at least in part reflect the presence of co-morbidities.