Langfristiger Effekt einer Lungenarterienembolie auf das Mortalitätsrisiko

by Johannes Eckelt
Doctoral thesis
Date of Examination:2026-01-19
Date of issue:2026-01-06
Advisor:PD Dr. Mareike K. Lankeit
Referee:PD Dr. Matthias Ebner
Referee:Prof. Dr. Michael Koziolek
Referee:Prof. Dr. Sabine Blaschke-Steinbrecher
Persistent Address: http://dx.doi.org/10.53846/goediss-11719

 

 

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Abstract

English

While numerous studies have investigated short-term outcomes after pulmonary embolism (PE), long-term mortality remains insufficiently studied. The objectives were investigate long-term outcomes in an unselected cohort of patients with PE. Therefore, a total of 896 consecutive patients with PE enrolled in a single-center registry between May 2005 and December 2017 were followed up for up to 14 years. The observed mortality rate was compared with the expected rate in the general population. The total follow-up time was 3908 patient-years (median, 3.1 years). The 1- and 5-year mortality rates were 19.7% (95% CI, 17.2%-22.4%) and 37.1% (95% CI, 33.6%-40.5%), respectively. The most frequent causes of death were cancer (28.5%), PE (19.4%), infections (13.9%), and cardiovascular events (11.6%). Late mortality (after >30 days) was more frequent than expected in the general population, a finding that was consistent in patients without cancer (the 5-year standardized mortality ratios were 2.77 [95% CI, 2.41-3.16] and 1.80 [95% CI, 1.50-2.14], respectively). Active cancer was the strongest risk factor for death between 30 days and 3 years (hazard ratio [HR], 6.51; 95% CI, 4.67-9.08) but was not associated with later mortality. Death after >3 years was predicted by age (HR, 1.86; 95% CI, 1.51-2.29 per decade), chronic heart failure (HR, 1.66; 95% CI, 1.02-2.70), and anemia (HR, 1.62; 95% CI, 1.09-2.41). In conclusion, the risk of mortality in patients with PE remained elevated compared with that in the general population throughout the follow-up period. The main driver of long-term mortality during the first 3 years was cancer. After that, mortality was predicted by age, chronic heart failure, and anemia.
Keywords: Pulmonary Embolism; Long-term Mortality after Pulmonary Embolism; Cardiovascular Mortality