Mortality, hospital discharges, and case fatality for pulmonary embolism in the Twin Cities: 1980-1995.

Pulmonary embolism (PE) causes substantial morbidity and mortality, but little information is available regarding recent secular trends for PE. This study determined trends for PE in adults ages 30 to 84 years in the Minneapolis-St. Paul metropolitan area from 1980 to 1995. The age-adjusted mortality rate for PE decreased approximately 50% during the study period; the rate ratio (RR) for 1992-95 compared to 1980-83 was 0.41 in men [95% confidence interval (CI) 0.31-0.55] and was 0.60 in women (95% CI 0.46-0.79). The hospital discharge rate for PE also decreased from 1980-83 to 1988-91 (RR 0.69, 95% CI 0.63-0.76 in men; RR 0.72, 95% CI 0.66-0.78 in women), but increased slightly between 1988-91 and 1992-95. The case fatality rate for PE decreased approximately 60% during the period (RR 0.38, 95% CI 0.28-0.51 in men; RR 0.37, 95% CI 0.28-0.50 in women). The PE trends were paralleled by declining hospital discharge rates for phlebitis and thrombophlebitis. These data support a changing natural history or possible improvements in the prevention, diagnosis, and treatment of PE between 1980 and 1995.