WHO Mortality Database Reveals Fewer Deaths from PE in the European Region Over the Past 15 Years

October 13th, 2019

Nearly 40,000 people still die from this preventable disorder in Europe every year

CHAPEL HILL, NC, USA, (October 13, 2019) — In Europe, the mortality related to pulmonary embolism, an acute life-threatening condition characterized by blood clots obstructing the lung arteries, has been cut in half since 2000, according to an analysis of data from the World Health Organization (WHO) Mortality Database published today in The Lancet Respiratory Medicine by an international team of scientists.

From 2000 to 2015, the age-standardized mortality due to pulmonary embolism decreased from about 13 deaths per 100,000 people per year to seven deaths per 100,000 people, among a population of 650 million living in 41 European countries, according to the study funded by the German Federal Ministry of Education and Research. The study is the first comprehensive analysis of pulmonary embolism-related mortality in Europe.

Despite these improvements, the study found that the mortality related to pulmonary embolism remains very high in Eastern Europe, and may be exhibiting an increasing trend in some low- and middle-income countries. This is similar to what has been observed for myocardial infarction and stroke, the two more frequent cardiovascular diseases, in prior analysis of the European population.

Pulmonary embolism caused every year an average of almost 40,000 deaths between 2013 and 2015, and represented a more frequent cause of death in younger women (15 to 55 years) than in men of the same age. As for the risk of developing pulmonary embolism, also the risk of dying from pulmonary embolism rose exponentially with age, the study found.

“As the global population ages, the medical, societal and economic costs related to pulmonary embolisms will grow,” says Stefano Barco, lead author of the study and researcher at the Center for Thrombosis and Hemostasis of the University Medical Center Mainz, Germany. “Therefore, efforts to implement large-scale preventive programs and evidence-based therapies must be maintained and expanded. Much remains to be done to diminish the burden of pulmonary embolism among younger women and better understand the reasons of the geographical differences in pulmonary embolism-related mortality.”

Although the interpretation of vital registration data should be cautious due to intrinsic limitations of this type of analyses, as we know that 60 percent of pulmonary emboli are due to hospital admission, it is likely that better prevention strategies in hospitalized patients and improved treatment of pulmonary embolism account for the decreasing mortality due to pulmonary embolisms in Europe, according to the authors.

In 2010, the England National Health Service (NHS) mandated the reporting of risk of venous thromboembolism (VTE) with a target of 95 percent of adult admissions. As a result, there has been a 15.4 percent reduction in deaths within 90 days after discharge across England.

“Using this approach to reduce the national incidence and in-hospital mortality of pulmonary embolisms in the U.K. has been an important strategy for decreasing deaths,” says Prof. Beverley Hunt, OBE, chair of the World Thrombosis Day Steering Committee. “Widespread adoption of NHS England’s systematic approach to thromboprophylaxis would be of huge benefit to WHO’s plan of reducing premature mortality from non-communicable disease by 25 percent by 2025.”

Global efforts, such as World Thrombosis Day on 13 October, are underway to build awareness and encourage countries to implement large-scale preventive programs to continue to reduce deaths due to thrombosis. Created by the International Society on Thrombosis and Haemostasis, World Thrombosis Day seeks to increase global awareness of thrombosis, including its causes, risk factors, signs/symptoms and evidence-based prevention and treatment. Ultimately, the campaign supports the World Health Assembly’s global target of reducing premature deaths by non-communicable disease by 25 percent by 2025.

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More About Pulmonary Embolism
Pulmonary embolism occurs when a piece of a blood clot breaks loose deep in the veins (deep vein thrombosis) and travels in the blood stream to the lungs causing a blockage in a blood vessel. Together, deep vein thrombosis and pulmonary embolism are known as venous thromboembolism and are referred to as blood clots. These can happen to anyone, but are a particular concern among hospitalized patients, who are more vulnerable because long periods of inactivity, surgery and certain health conditions which increase the risk of clotting.

About the ISTH
Founded in 1969, the ISTH is the leading worldwide not-for-profit organization dedicated to advancing the understanding, prevention, diagnosis and treatment of thrombotic and bleeding disorders. ISTH is an international professional membership organization with more than 5,000 clinicians, researchers and educators working together to improve the lives of patients in more than 98 countries around the world. Among its highly regarded activities and initiatives are education and standardization programs, research activities, meetings and congresses, peer-reviewed publications, expert committees and World Thrombosis Day on 13 October. Visit ISTH online at www.isth.org.

Media Inquiries:
Sam Perry, ISTH Campaign Manager
Sam_Perry@isth.org
+1 (919) 929-3807

World Thrombosis Day Empowers People Around the World to Recognize Life Threatening Blood Clots

CHAPEL HILL, N.C., October 9, 2019 — On October 13, the World Thrombosis Day campaign shares an important message: patients, regardless of where they live, should be able to to expect that their hospital stay is safe and that the risk of adverse events such as thrombosis is minimized. Thrombosis is the formation of potentially deadly blood clots in an artery or vein. With one in four deaths due to thrombosis-related conditions each year, the campaign encourages health systems to have risk assessment protocols in place and patients to be informed and empowered to ask questions regarding their care.

Thrombosis can trigger a host of life-threatening medical conditions, including heart attack, stroke and venous thromboembolism (VTE). VTE occurs when one or more blood clots form in a deep vein, most often in the leg (deep vein thrombosis). The clot can travel in the circulation and lodge in the lungs (a condition known as pulmonary embolism, PE). Approximately 10 million cases of VTE occur annually. This preventable condition, which can be fatal, is overlooked as a major public health crisis.

“Hospital-acquired blood clots are a global problem,” says Prof. Beverley Hunt, OBE, chair of the World Thrombosis Day Steering Committee. “In a major study sponsored by the World Health Organization (WHO), it accounted for more deaths and disability in low- and middle-income countries than other patient safety issues, including hospital-acquired pneumonia, catheter-related bloodstream infections and drug errors. Because of this, the World Thrombosis Day campaign places a global spotlight on hospital-acquired blood clots to raise awareness of this common and under-recognized preventable health issue.”

Sixty percent of blood clots are linked to hospitalization. In England, however, Dr. Hunt points out that figures have been falling over the last decade thanks to mandated VTE prevention measures instituted in hospitals by the National Health Service (NHS). Since 2010, England has seen a 15.4 percent reduction in deaths within 90 days after hospital discharge.

While some hospitals and healthcare systems have adopted similar measures for preventing VTE, that is not true everywhere. This means patients must be proactive in speaking with their care providers about the steps they can take to identify and prevent blood clots. During their stay at the hospital and after being discharged, patients should be alert for signs and symptoms of blood clots, such as leg pain and tenderness, redness and swelling, shortness of breath, rapid breathing, chest pain and coughing up blood.

Thrombosis survivor Scott Shields of Arlington, Virginia, says, “A car crash when I was 32 left me with multiple life-threatening injuries. But when I was recovering in the hospital, I developed a deep vein thrombosis (DVT) in my left thigh. Because I was communicating with my doctors daily during physical therapy sessions, I was able to bring their attention to this new, sudden pain in my leg, and get rapid treatment.”

As Shields indicates, an open line of communication with healthcare providers is essential, and patients should feel empowered to advocate for their own care. Hospitalized patients should take the following steps to help assess their risk and prevent VTE:

  • Ask your provider for a VTE risk assessment, a tool or questionnaire that gathers information about age, medical history, medications, and specific lifestyle factors to discern a patient’s potential risk for developing blood clots.
  •  Ask about treatment options like compression stockings or anti-clotting medication to help prevent VTE.
  • Follow prescribed treatments, including medication, as ordered, and ask questions if you have any.
  • Stay active and moving as much as possible while in the hospital and after discharge.

For more information about blood clots, visit the World Thrombosis Day website. World Thrombosis Day is on October 13 each year and is led by the International Society on Thrombosis and Haemostasis (ISTH).

About World Thrombosis Day
Launched in 2014 and held annually on 13 October, World Thrombosis Day (WTD) aims to increase public, healthcare professional and health care systems’ awareness of thrombosis and, ultimately, to reduce deaths and disabilities from thromboembolic disease through a greater awareness of its causes, risk factors, signs and symptoms, and evidence-based prevention and treatment. WTD’s mission supports the World Health Assembly’s global target of reducing premature deaths by non-communicable disease by 25 percent by 2025, as well as the WHO global action plan for the prevention and control of non-communicable diseases in the 2013-2020 time-frame. Visit www.worldthrombosisday.org for more information and to get involved.

About the ISTH
Founded in 1969, the ISTH is the leading worldwide not-for-profit organization dedicated to advancing the understanding, prevention, diagnosis and treatment of thrombotic and bleeding disorders. ISTH is an international professional membership organization with more than 5,000 clinicians, researchers and educators working together to improve the lives of patients in more than 98 countries around the world. Among its highly regarded activities and initiatives are education and standardization programs, research activities, meetings and congresses, peer-reviewed publications, expert committees and World Thrombosis Day on 13 October. Visit ISTH online at www.isth.org.

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