Incidence and Outcomes of Emergency Medical Service Treated Pulmonary Embolism in Victoria, Australia; A Population-Based Cohort Study.
Emergency medical service-treated pulmonary embolism carries a 7% 30-day mortality rate.
Incidence and Outcomes of Emergency Medical Service Treated Pulmonary Embolism in Victoria, Australia; A Population-Based Cohort Study.
Pulmonary embolism (pulmonary embolism) is a major cause of cardiovascular morbidity and mortality.
We aimed to determine the incidence, clinical characteristics, and outcomes of patients with emergency medical service-treated pulmonary embolism in Victoria, Australia.
This population-based cohort study included adults attended by a single statewide emergency medical service provider between January 1, 2015, and November 28, 2020, with an in-hospital primary diagnosis of pulmonary embolism.
about 1 in 14 patients died within a month
Among 3,976,574 emergency medical service-attended patients (29.6 million person-years), 6,769 had a confirmed pulmonary embolism, yielding an incidence of 22.9 per 100,000 person-years (95% CI, 22.3-23.4), which increased over the study period from 22.86 in 2015 to 22.84 per 100,000 person years in 2020 (P trend = 0.04).
The mean (SD) age was 64.7 (17.3) years.
Independent predictors of 30-day mortality included older age, pre-hospital cardiac arrest, pre-existing malignancy, diabetes, and altered vital signs (low systolic blood pressure, hypoxia, and tachypnea).
Pulmonary embolism treated by emergency medical service is increasingly common and carries a substantial short-term mortality risk.
These findings suggest that established risk stratification tools may help optimize prehospital triage and improve systems of care, however, further dedicated studies are required.