The epidemiology of pulmonary embolism: Racial contrasts in incidence and in-hospital case fatality

Dona Schneider, David E. Lilienfeld, Wansoo Im

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56 Scopus citations


Mortality from pulmonary embolism (PE) has declined in the United States over the past two decades, yet significant racial disparities persist with the age-adjusted rates for blacks about twice those for whites. Incidence studies to date have not been successful in defining reasons for this disparity, primarily because they have not enrolled sufficient numbers of blacks to allow for racial comparisons. This study overcomes that limitation by using New Jersey hospital discharge data as a surrogate measure for PE incidence. It examines whether differences in access to care, in-hospital case fatality, discharge planning or other factors might help explain the observed patterns. Our results revealed an elevation in the incidence of PE among blacks compared with whites, similar to the contrasts in mortality. In-hospital case fatality did not differ notably between blacks and whites, indicating that treatment in-hospital is an unlikely contributing factor. We found differences in hospital discharge planning and insurance status, suggesting that these factors may play a role. Our results point to the need for longitudinal studies on the natural history of the disease to better identify and hopefully modify the risk factors responsible for the persistent disparity in mortality from PE.

Original languageEnglish (US)
Pages (from-to)1967-1972
Number of pages6
JournalJournal of the National Medical Association
Issue number12
StatePublished - Dec 2006

All Science Journal Classification (ASJC) codes

  • Medicine(all)


  • Epidemiology
  • Pulmonary embolism
  • Racial disparities


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