Trends in pulmonary embolism incidence in Spain (2016-2022): an analysis of differences among autonomous communities

The regional distribution of pulmonary embolism (PE) incidence within Spain is unknown. This study aims to describe the temporal and regional distribution of PE in Spain during the period 2016-2022.

All PE episodes during the study period were identified using the Minimum Basic Data Set. Age-standardized annual incidence rates were calculated for each autonomous cities and communities. Temporal trends were evaluated using joinpoint regression. For each community, the incidence rate ratio (IRR) relative to all others was estimated using a negative binomial regression model, adjusted for sex and age.

A total of 229,728 episodes were identified (49.5% women, mean age 70.3 ± 15.7 years). Nationwide, the incidence increased from 53.16-78.49 cases per 100,000 inhabitants (annual percentage change, APC, 9.2%, p = 0.007). The increase was most pronounced in the Balearic Islands, Murcia, and Andalusia (APC 14.4%, p = 0.04; 14.3%, p = 0.001; 13.4%, p = 0.003), and less so in Galicia, La Rioja, and Extremadura (APC 4.1%, p = 0.021; 5.4%, p = 0.003; 5.7%, p = 0.008). The change was not significant in Asturias, Madrid, Melilla, and Ceuta. The highest sex- and age-adjusted incidence rate for the period was observed in Madrid (IRR 1.29; 95% CI: 1.26-1.32) and the lowest in Ceuta (IRR 0.59; 95% CI: 0.5-0.69).

The incidence of PE in Spain increased during the period 2016-2022, with this increase being more pronounced in the southern and eastern regions of the Iberian Peninsula. The results of this study may contribute to maintain an adequate level of awareness in concerned professionals.