Ritter, Julia

Abstract RATIONALE: The diagnosis of Pulmonary Embolism (PE) is associated with high mortality and morbidity. In patients with cancer, high-risk pulmonary emboli further escalate these risks. Ensuring access to the necessary resources for appropriate intervention is crucial for improving patient outcomes. However, the resource-intensive nature of managing multiple life-threatening conditions can create barriers for certain demographic populations, leading to disparities in outcomes. To address this issue, we explored mortality trends among diverse groups based on gender, ethnicity, and geographical background in the United States from 1999-2000. METHODS: We obtained mortality data from death certificate queries in the Centers for Disease Control and Prevention Wide-range Online Data for Epidemiologic Research database. Queries included all decedents with the underlying cause of death being PE (I26) in patients with a diagnosis of cancer (C00 – C97). Age-adjusted mortality rates (AAMR) per 100,000 people were compared across demographic populations, and 95% Confidence Intervals were standardized to the year 2000. Log-linear regression models were utilized to assess temporal mortality shifts and calculate annual percentage change (APC) from 1999 to 2020. RESULTS: A total of 179483 PE-related deaths was reported in patients with cancer. The AAMR increased from 2.14 [2.08-2.19] in 1999 to 3.05 [3.00-3.11] in 2020. The cumulative AAMR was 2.42 [2.41-2.43] with an average APC of +1.56% (p<0.001). The mortality rate accelerated following the year 2016, with the years prior having an APC of +0.69%, (p<0.001) and the years following having an APC +5.33% (p<0.001). A higher mortality was observed in males (AAMR 2.71 [2.69-2.73]) than females (2.20 [2.18-2.21]), in rural communities (AAMR 2.50 [2.47-2.53]) compared to urban communities (AAMR 2.38 [2.37-2.40]), and in non-Hispanic (AAMR 2.48 [2.47-2.49]) populations over Hispanic populations (AAMR 1.45 [1.42-1.48]). Mortality was highest in the Black population (AAMR 3.65 [3.60-3.69]), followed by White population (AAMR 2.33 [2.32-2.34]), American Natives (AAMR 1.43 [1.33-1.54]), and Asian (AAMR 1.04 [1.00-1.08]). Geographically, Midwest (AAMR 2.58 [2.56-2.61]) had the highest mortality while the South (AAMR 2.26 [2.24-2.28]) had the lowest mortality. CONCLUSIONS: We identified significant disparities in mortality related to pulmonary embolism (PE) among cancer patients across different demographic populations. Further investigation into these healthcare inequities is essential for addressing the disparities affecting various groups.