Dynamic changes of all-cause of burden associated with pulmonary embolism in Shanghai Pudong, 2005-2021 and prediction to 2035: a real-world study

Pulmonary embolism (PE)-related deaths are rising amid population aging, yet comprehensive burden data remain scarce. We quantified all-cause PE mortality in Shanghai Pudong (2005–2021) and projected trends to 2035. Epidemiological transition theory and burden-of-disease metrics (YLL, ASMRW) framed the analysis; Joinpoint, ARIMA, and decomposition methods traced temporal and demographic drivers. Longitudinal population-based study using ICD-10-coded death records; calculated CMR, ASMRW, and YLL; modeled future burden and aging impact. Of 1,144 PE-related deaths, the top underlying causes were coronary heart disease (13.02%), PE (11.98%), and chronic lower respiratory disease (10.2%). ASMRW = 0.89/105; CMR = 2.37/105; YLL rate = 22.88/105. Population aging raised CMR by 30.72% annually (95% confidence interval (CI) 23.5–38.4%). By 2035, CMR, ASMRW, and YLL rates are expected to rise 3.89, 2.94, and 2.17% per year, respectively (all p < 0.001). Aging and comorbidities are fueling a sustained surge in PE mortality. Tailored prevention and early intervention strategies are urgently needed to mitigate this growing public health burden.