The primary outcome was overall mortality within 90 days of PE diagnosis. We assessed the clinical outcomes using patient or proxy interviews, interview of the patient’s primary care physician, and/or hospital chart review. A committee of three blinded, independent clinical experts adjudicated the cause of death. Death was judged to be a definite fatal PE if it was confirmed by autopsy, or if death followed a clinically severe PE, either initially or after an objectively confirmed recurrent event. Death in a patient who died suddenly or unexpectedly was classified as possible fatal PE. Final classification was made on the basis of the full consensus of this committee.