PT - JOURNAL ARTICLE AU - Zhenguo Zhai AU - Dingyi Wang AU - Jieping Lei AU - Yuanhua Yang AU - Xiaomao Xu AU - Yingqun Ji AU - Qun Yi AU - Hong Chen AU - Xiaoyun Hu AU - Zhihong Liu AU - Yimin Mao AU - Jie Zhang AU - Juhong Shi AU - Zhu Zhang AU - Sinan Wu AU - Qian Gao AU - Xincao Tao AU - Wanmu Xie AU - Jun Wan AU - Yunxia Zhang AU - Shuai Zhang AU - Kaiyuan Zhen AU - Zhonghe Zhang AU - Baomin Fang AU - Chen Wang ED - , TI - Trends in risk stratification, in-hospital management and mortality of patients with acute pulmonary embolism: an analysis from the China pUlmonary thromboembolism REgistry Study (CURES) AID - 10.1183/13993003.02963-2020 DP - 2021 Oct 01 TA - European Respiratory Journal PG - 2002963 VI - 58 IP - 4 4099 - http://erj.ersjournals.com/content/58/4/2002963.short 4100 - http://erj.ersjournals.com/content/58/4/2002963.full SO - Eur Respir J2021 Oct 01; 58 AB - Similar trends of management and in-hospital mortality of acute pulmonary embolism (PE) have been reported in European and American populations. However, these tendencies are not clear in Asian countries. We retrospectively analysed the trends of risk stratification, management and in-hospital mortality for patients with acute PE through a multicentre registry in China (CURES).Adult patients with acute symptomatic PE were included between 2009 and 2015. Trends in disease diagnosis, treatment and death in hospital were fully analysed. Risk stratification was retrospectively classified by haemodynamic status and the simplified Pulmonary Embolism Severity Index (sPESI) score according to the 2014 European Society of Cardiology/European Respiratory Society guidelines.Among 7438 patients, the proportions with high (haemodynamic instability), intermediate (sPESIā‰„1) and low (sPESI=0) risk were 4.2%, 67.1% and 28.7%, respectively. Computed tomographic pulmonary angiography was the most widely used diagnostic approach (87.6%) and anticoagulation was the most frequently adopted initial therapy (83.7%). Between 2009 and 2015, a significant decline was observed for all-cause mortality (from 3.1% to 1.3%, adjusted pfor trend=0.0003), with a concomitant reduction in the use of initial systemic thrombolysis (from 14.8% to 5.0%, pfor trend<0.0001). The common predictors for all-cause mortality shared by haemodynamically stable and unstable patients were co-existing cancer, older age and impaired renal function.The considerable reduction of mortality over the years was accompanied by changes in initial treatment. These findings highlight the importance of risk stratification-guided management throughout the nation.The considerable reduction over the years in the mortality of acute PE during hospitalisation can plausibly be associated with risk stratification-guided management. This finding highlights the importance of implementing evidence-based guidelines throughout the nation. https://bit.ly/2P6gV7I