Pulmonary embolism (PE) remains a major cause of cardiovascular mortality. Existing literature suggests that disparities in PE management may influence outcomes, but robust, population-wide data are lacking, particularly in France.

To evaluate all-cause mortality among adults hospitalized for PE in France and to identify key demographic, clinical, and institutional determinants of outcomes. Specific factors of interest include patient characteristics (e.g., age, comorbidities), hospital attributes (PE case volume and public vs. private status), timeliness of management (diagnosis and treatment delays), outpatient care continuity, and initial treatment strategies, in order to assess their association with mortality and highlight potential care disparities.

We conducted a national retrospective cohort study using the French National Health Data System (SNDS) epi-phare.fr. All adults (≥ 18 years) hospitalized with a diagnosis of PE from 2010 through 2023 were included, identified by CIM-10 codes I26 (pulmonary embolism) and I82 (other venous embolism and thrombosis). For each case, we extracted patient demographics, co-morbidities, and key care parameters: hospital type (public or private) and annual PE case volume, timing of diagnostic imaging and treatment initiation, initial treatment modality (anticoagulation ± thrombolysis or other interventions), and post-discharge outpatient follow-up. The primary outcome is all-cause mortality (in-hospital and post-discharge). Descriptive statistics were used to characterize patient profiles and care pathways. Full multivariable statistical analyses (to evaluate independent predictors of mortality) are in progress; thus, only preliminary descriptive results are reported here.

Preliminary data extraction confirms substantial heterogeneity in patient and hospital profiles. The full cohort encompasses over 500,000 PE cases ( Figure 1 ). First analyses focus on descriptive trends, showing broad variability in treatment settings and highlighting underuse of outpatient care. Full results on mortality and care determinants are under analysis.

This ongoing study leverages national-scale data to investigate PE management in France. While initial findings highlight care heterogeneity, the final analyses aim to clarify how clinical and systemic factors influence mortality. These insights may guide future standardization efforts and improve equity in PE care.