Abstract
Background Studies have reported seasonal variations regarding the incidence and the short-term mortality of pulmonary embolism (PE). The aim of this study was to identify sex-specific and age-related differences in seasonal patterns regarding hospitalisations and mortality of PE patients.
Methods We analysed the impact of seasons on incidence and in-hospital mortality of male and female hospitalised PE patients in Germany (2005–2015) based on the German nationwide inpatient sample.
Results The German nationwide inpatient sample comprised 885 806 hospitalisations due to PE (2005–2015). Seasonal variations of both incidence (p=0.021) and in-hospital mortality (p<0.001) were of significant magnitude. Quarterly annual incidence (25.5 versus 23.7 of 100 000 citizens per year, p=0.021) and in-hospital mortality (17.0% versus 16.7%, p=0.008) were higher in winter than in summer. Risk of in-hospital mortality in winter was slightly higher (OR 1.03 (95% CI 1.01–1.06), p=0.015) compared to summer, independently of sex, age and comorbidities. Additionally, we observed sex-specific differences during seasons: the highest number of hospitalisations of PE patients of both sexes was during winter, whereas the nadir of male patients was in spring and that of female patients was in summer. Both sexes showed a maximum of in-hospital mortality in spring. Seasonal variation regarding incidence and mortality was pronounced in older patients.
Conclusion Incidence and the in-hospital mortality of PE patients showed a significant seasonal variation with sex-specific differences. Although it has to be hypothesised that the seasonal variation of PE is multifactorially dependent, variation in each season was not explained by seasonal differences regarding age, sex and the prevalence of important comorbidities.
Abstract
Incidence and mortality of PE patients shows a seasonal variation with sex-specific differences. Seasonal variation of PE is caused multifactorially but not primarily explained by age, sex or comorbidities. https://bit.ly/2XWxULT
Footnotes
Data availability: We have no permission to share the data of the nationwide inpatient sample.
Conflict of interest: K. Keller reports that this study was supported by the German Federal Ministry of Education and Research (BMBF 01EO1503) via an Institutional Grant for the Center for Thrombosis and Hemostasis. The authors are responsible for the contents of this publication.
Conflict of interest: L. Hobohm reports lecture honoraria from MSD outside the submitted work, and that this study was supported by the German Federal Ministry of Education and Research (BMBF 01EO1503) via an Institutional Grant for the Center for Thrombosis and Hemostasis. The authors are responsible for the contents of this publication.
Conflict of interest: T. Münzel reports that this study was supported by the German Federal Ministry of Education and Research (BMBF 01EO1503) via an Institutional Grant for the Center for Thrombosis and Hemostasis. The authors are responsible for the contents of this publication. T. Münzel is principal investigator of the DZHK (German Center for Cardiovascular Research), Partner Site Rhine-Main, Mainz, Germany.
Conflict of interest: S.V. Konstantinides reports consultancy and lecture honoraria from Bayer, Boehringer Ingelheim, Daiichi-Sankyo, MSD, Pfizer and Bristol-Myers Squibb, and institutional grants from Actelion, Bayer, Boehringer Ingelheim, Daiichi-Sankyo, Pfizer and Bristol-Myers Squibb, all outside the submitted work; and that this study was supported by the German Federal Ministry of Education and Research (BMBF 01EO1503) via an Institutional Grant for the Center for Thrombosis and Hemostasis. The authors are responsible for the contents of this publication.
Conflict of interest: M. Lankeit reports consultancy and lecture honoraria from Actelion, Bayer, Daiichi-Sankyo, MSD, Pfizer and Bristol-Myers Squibb, and research funding from BRAHMS and Thermo Fisher scientific, all outside the submitted work; and that this study was supported by the German Federal Ministry of Education and Research (BMBF 01EO1503) via an Institutional Grant for the Center for Thrombosis and Hemostasis. The authors are responsible for the contents of this publication.
Support statement: This study was supported by the German Federal Ministry of Education and Research (BMBF 01EO1503). The authors are responsible for the contents of this publication. Funding information for this article has been deposited with the Crossref Funder Registry.
- Received March 17, 2020.
- Accepted April 15, 2020.
- Copyright ©ERS 2020
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