Trend of in-hospital deaths by pulmonary embolism in Ecuador. Findings from 2011-2018 national reports.

Background: Pulmonary embolism (PE) is a potentially fatal disease related to venous thromboembolism. Information regarding this pathology in the Ecuadorian population is limited. This study aims to present the PE hospital mortality rates (HMR) in Ecuador, analyze its trend and risk factors.

Methods: An epidemiological, descriptive and cross-sectional study based on the reporting and trend analysis of pulmonary embolism HMR in the Ecuadorian population from 2011 to 2018 through the governmental database of the Ecuadorian National Statistics and Census Institute, was conducted.

Results: In Ecuador, PE hospital discharges (HD) varied from 358 in 2011 to 424 in 2018. More than 60% of patients were older than 60 years. Also, the frequency of PE with acute cor pulmonale increased from 3.07% in 2011 to 16.98% in 2018 (P<0.05). The HMR by 100 HD increased between 2011 (12.85/100 HD) and 2018 (17.02/100 HD) (P<0.05), with the highest rate reported in 2017 (21.52/100 HD). In the period studied, 505 in-hospital deaths were reported in patients with PE, the average age in this group was 64.3 years, 58.42% were female, and 10.89% had acute cor pulmonale (ICD-10 I26.0). Risk factors associated with PE in-hospital death were acute cor pulmonale (OR 1.63, 95% CI: 1.18 to 2.25, P<0.01) and 60 years or more (OR 1.73, 95% CI 1.40-2.15, P<0.01).

Conclusion: A significant increase in PE HMR in Ecuador was found. Also, acute cor pulmonale and age of 60 years or more may be potential risk factors for in-hospital death in patients with PE.