Epidemiology of pulmonary embolism: mortality in a general population

This report describes the basic epidemiologic characteristics of fatal pulmonary embolism as it was recognized in the adult white population of Washington County, Maryland, from 1963 to 1975. Demographic and personal characteristics considered are age, sex, marital status, educational level, adequacy of housing, cigarette smoking, and religious service attendance. There were 316 deaths with pulmonary embolism mentioned on the death certificate during the 12 years of this study. Death was attributed to pulmonary embolism in 55 instances (17%) and to other thromboembolic diseases in 41 cases (13%). Age and educational level were the only sociodemographic variables significantly associated with risk of fatal pulmonary embolism. Mortality rose logarithmically with age up to age 75. Persons with less than 8 years of schooling had the highest rates, but the association with educational level was not linear. There was a suggestion that cigarette smoking was also associated with the certified presence of pulmonary embolism at death. Heart disease and cancer were mentioned on the death certificates of persons dying with pulmonary embolism less often than on death certificates in general, casting doubt on an etiologic association.