Sex Differences in Outcomes of Percutaneous Pulmonary Artery Thrombectomy in Patients With Pulmonary Embolism

BACKGROUND The sex differences in utilization, safety outcomes, and healthcare resource utilization of patients with PE undergoing percutaneous pulmonary artery thrombectomy are not well characterized. RESEARCH QUESTION What are the sex differences in outcomes for patients diagnosed with pulmonary embolism (PE) undergoing percutaneous pulmonary artery thrombectomy? STUDY DESIGN AND METHODS This retrospective cross-sectional study used national inpatient claims data to identify patients in the U.S. with a discharge diagnosis of PE who underwent percutaneous thrombectomy between January 2016 and December 2018. We evaluated the demographics, comorbidities, safety outcomes (in-hospital mortality) and healthcare resource utilization (discharge to home, length of stay, and hospital charges) of PE patients undergoing percutaneous thrombectomy. RESULTS Among 1,128,904 patients with a diagnosis of PE between 2016 and 2018, 5,160 (0.5%) patients underwent percutaneous pulmonary artery thrombectomy. When compared to males, females had higher procedural bleeding (16.9 vs. 11.2%; P < 0.05), required more blood transfusions (11.9% vs. 5.7%; p < 0.05), and had more vascular complications (5.0% vs. 1.5%; P < 0.05). Females had higher in-hospital mortality (16.9% vs 9.3%; adjusted OR: 1.9; 95% CI 1.2 to 3.0; P = 0.003) when compared to males. Although length of stay and hospital charges were similar to males, females were less likely to be discharged home after surviving hospitalization (47.9% vs. 60.3%; adjusted OR= 0.7; 95% CI: 0.50 to 0.99; P = 0.04). INTERPRETATION In this large nationwide cohort, females with PE who underwent percutaneous thrombectomy had higher morbidity and in-hospital mortality compared to males.