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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Aim&#58; This study aims to analyse trends in Venous thromboembolism &#40;VTE&#41; mortality in the Spanish Autonomous Communities &#40;ACs&#41; from 1999 to 2022&#44; with a focus on identifying regional disparities and informing targeted public health interventions&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Methods&#58; Age-standardized mortality rates &#40;ASMRs&#41; were calculated using the European standard population as a reference&#46; Joinpoint regression analysis was employed to identify significant changes in mortality trends&#44; and geographical analysis was conducted using Bayesian inference to assess regional variations in mortality risk&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Results&#58; From 1999 to 2022&#44; Spain recorded 59&#44;515 VTE-related deaths&#44; with a higher proportion in women &#40;59&#46;4&#37;&#41; compared to men &#40;40&#46;6&#37;&#41;&#46; On a nationwide scale&#44; VTE ASMRs showed a general decline for both men and women&#44; with rates decreasing from 11&#46;0 to 5&#46;1 per 100&#44;000 in men and from 9&#46;2 to 4&#46;4 per 100&#44;000 in women&#46; However&#44; this decline was not uniform across all regions or demographic groups&#46; Notably&#44; mortality rates among younger individuals&#44; particularly men&#44; increased during the study period&#44; highlighting the need for targeted interventions&#46; Analysis revealed significant regional disparities&#44; with higher mortality risks observed in Extremadura&#44; Aragon&#44; Navarre&#44; and Andalusia&#44; particularly for women&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Conclusions&#58; This study provides valuable insights into the complex landscape of VTE mortality in Spain&#46; While the overall decline in mortality is encouraging&#44; persistent regional disparities and rising rates among younger individuals underscore the need for ongoing surveillance and targeted interventions&#46;</p></span>"
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ORIGINAL RESEARCH ARTICLE
DOI: 10.1016/j.arbres.2024.10.015
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Regional Disparities and Trends in Venous Thromboembolism Mortality in Spain (1999-2022)
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Lucia Cayuela1, Anna Michela Gaeta2,
Corresponding author
annamichelagaeta@hotmail.it

Correspondence: Pneumology Department. Hospital Universitario Severo Ochoa, Leganés, Spain
, Remedios Otero3,4,5, Luis Jara-Palomares3,4,5, Isabel Mendo Pedrajas1, Aurelio Cayuela6
1 Department of Internal Medicine, Hospital Universitario Severo Ochoa, Leganés, Spain
2 Pulmonology Department. Hospital Universitario Severo Ochoa, Leganés, Spain
3 Medical Surgical Unit of Respiratory Diseases, Hospital Universitario Virgen del Rocío, 41013 Seville, Spain
4 Instituto de Biomedicina de Sevilla (IBiS), Consejo Superior de Investigaciones Cientificas (CSIC), Universidad de Sevilla, 41013 Sevilla, Spain
5 Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
6 Unit of Public Health, Prevention and Health Promotion. South Seville Health Management Area, Seville, Spain
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Abstract

Aim: This study aims to analyse trends in Venous thromboembolism (VTE) mortality in the Spanish Autonomous Communities (ACs) from 1999 to 2022, with a focus on identifying regional disparities and informing targeted public health interventions.

Methods: Age-standardized mortality rates (ASMRs) were calculated using the European standard population as a reference. Joinpoint regression analysis was employed to identify significant changes in mortality trends, and geographical analysis was conducted using Bayesian inference to assess regional variations in mortality risk.

Results: From 1999 to 2022, Spain recorded 59,515 VTE-related deaths, with a higher proportion in women (59.4%) compared to men (40.6%). On a nationwide scale, VTE ASMRs showed a general decline for both men and women, with rates decreasing from 11.0 to 5.1 per 100,000 in men and from 9.2 to 4.4 per 100,000 in women. However, this decline was not uniform across all regions or demographic groups. Notably, mortality rates among younger individuals, particularly men, increased during the study period, highlighting the need for targeted interventions. Analysis revealed significant regional disparities, with higher mortality risks observed in Extremadura, Aragon, Navarre, and Andalusia, particularly for women.

Conclusions: This study provides valuable insights into the complex landscape of VTE mortality in Spain. While the overall decline in mortality is encouraging, persistent regional disparities and rising rates among younger individuals underscore the need for ongoing surveillance and targeted interventions.

Keywords:
Venous thromboembolism
Deep vein thrombosis
Pulmonary embolism
Mortality trends
Spain
Regional disparities
public health
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