Short-Term and Long-Term Mortality of Pulmonary Embolism Patients Admitted to the ICU in the Netherlands

OBJECTIVES: To describe the short-term and long-term mortality of pulmonary embolism patients admitted to the ICU. DESIGN: Retrospective cohort study of data from the Netherlands Intensive Care Evaluation registry. SETTING: All ICUs in the Netherlands. PATIENTS: All adult critically ill patients (≥ 18 yr) with pulmonary embolism as ICU admission diagnosis between 2013 and 2023 were included in the study. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The primary outcome is hospital mortality for patients with pulmonary embolism admitted to the ICU, as this represents short-term outcomes of pulmonary embolism and its treatment. The secondary outcome was 1-year mortality as a long-term outcome. Next, we compared patient characteristics and outcomes for survivors and nonsurvivors of the hospital admission. Of 10,210 eligible patients, 1,506 patients died (14.6%) during admission. This hospital mortality rate was higher in high-risk pulmonary embolism patients (n = 1372, 25.4%) than in non-high-risk pulmonary embolism patients (n = 134, 2.8%). Multivariable analysis also shows a higher 1-year mortality rate in high-risk pulmonary embolism patients than in non-high-risk pulmonary embolism patients (hazard ratio [HR], 3.98; CI, 3.59-4.40). The 1-year mortality of hospital survivors after hospital discharge is also higher in high-risk pulmonary embolism patients than in non-high-risk pulmonary embolism patients (HR, 1.70; CI, 1.49-1.96). CONCLUSIONS: This nationwide registry study confirmed that high-risk pulmonary embolism patients have a higher mortality than patients with non-high-risk pulmonary embolism admitted to the ICU. The unfavorable difference in mortality risk persists in the first year after hospital discharge. These numbers should be considered when making management decisions in patients with pulmonary embolism.