Addressing the rising trend of high-risk pulmonary embolism mortality: clinical and research priorities

Abstract

Background: Deaths from high-risk pulmonary embolism (PE) appear to have in-creased in the US over the last decade. Modifiable risks contributing to this worrisometrend present opportunities for physicians, researchers, and healthcare policymakersto improve care.Methods: We sought to contextualize contemporary, high-risk PE epidemiology andexamine clinical trials, quality improvement opportunities, and healthcare policy ini-tiatives directed at reducing mortality.Results: We observed significant and modifiable excess mortality due to high-risk PE.We identified several opportunities to improve care including: (1) rapid translationof forthcoming data on reperfusion strategies into clinical practice; (2) improved riskstratification tools; (3) quality improvement initiatives to address presumptive anti-coagulation practice gaps; and (3) adoption of health policy initiatives to establishpulmonary embolism response teams and address the social determinants of health.Conclusion: Addressing knowledge and practice gaps in intermediate and high-riskPE management must be prioritized and informed by forthcoming high-quality data.Implementation efforts are needed to improve acute PE management and resolvetreatment disparities