Effect Clinical Characteristics and Outcomes of Acute Pulmonary Embolism in Older Adults: A Comparison of Patients Aged 65–75 Years and ≥75 Years

Q: What are the key findings of this study?

Age ≥75 years was associated with higher unadjusted in-hospital mortality than age 65-75 years in acute pulmonary embolism (12.2% vs 3.4%), but was not an independent predictor after adjustment.

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Acute Pulmonary Embolism (n=188). Intervention: Age ≥75 years vs. Age 65-75 years. Primary outcome: In-hospital mortality (OR 3.944, 95% CI 1.083-14.364, p=0.037).

Q: What does this research mean for the field?

In patients hospitalized for acute pulmonary embolism, age ≥75 years is associated with a significantly higher mortality rate, increased cardiac stress markers, and greater right heart burden compared to patients aged 65-75 years. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Gökçe Külah; Ayşe Çapar; Harun Çıtlak; Şeyma Başlılar

doi:10.35514/mtd.2026.144

August 29, 2026Maltepe Tıp DergisiOpen Access

Effect Clinical Characteristics and Outcomes of Acute Pulmonary Embolism in Older Adults: A Comparison of Patients Aged 65–75 Years and ≥75 Years

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Key result

Age ≥75 linked to higher PE in-hospital mortality, but loses significance after adjustment.

OR 3.944
95% CI 1.083-14.364
P=0.037
n=188

Why the study?

Pulmonary embolism is a major cause of morbidity and mortality particularly in older groups, motivating an examination of the effect of age on disease course in patients aged 65 and older.

Does age ≥75 years compared to 65-75 years worsen clinical outcomes in patients with acute pulmonary embolism?

Key Points

To compare clinical presentations, laboratory markers, echocardiographic findings, and clinical outcomes between acute pulmonary embolism patients aged 65–75 years and those aged 75 years and older.
Transthoracic echocardiography, demographic features, laboratory parameters (including troponin, pro-BNP, and D-dimer), and clinical courses were gathered from hospital medical records.
Multivariable logistic regression models were conducted to determine independent predictors of in-hospital mortality and intensive care unit admission.
Patients aged ≥75 years had higher in-hospital mortality compared with those aged 65–75 years (12.2% vs. 3.4%, p=0.042) and a greater need for intensive care admission (34.1% vs. 15.6%, p=0.016).
Right ventricular dilatation was detected significantly more often in patients aged ≥75 years than in those aged 65–75 years (36.1% vs. 3.4%, p<0.001).
In multivariable analysis, right ventricular dilatation independently predicted in-hospital mortality (OR 5.188, 95% CI 1.017–26.465, p=0.048) and intensive care admission (OR 5.434, 95% CI 1.189–24.832, p=0.029), whereas age ≥75 years was not an independent predictor.

Study Design

Type

Observational (n=188)

Multicenter

No

Structured PICO

Does age ≥75 years compared to 65-75 years worsen clinical outcomes in patients with acute pulmonary embolism?

P

Population

188 patients aged 65 years and older hospitalized with acute pulmonary embolism, evaluated retrospectively to compare clinical characteristics and outcomes between those aged 65-75 and ≥75 years.

E

Exposure

Age ≥75 years

C

Comparator

Age 65-75 years

O

Outcome

In-hospital mortality and ICU admissionhard clinical

Main Result

Odds Ratio: 3.944 (95% CI 1.083–14.364)

Absolute Event Rate: 12.2% vs 3.4%

p-value: p=0.037

While older patients (≥75 years) with acute pulmonary embolism have worse unadjusted outcomes, advanced age is not an independent predictor of in-hospital mortality or ICU admission when adjusting for disease severity markers like right ventricular dilatation.

Limitations

Retrospective, single-center design with a relatively small sample size
Small number of mortality events may have reduced statistical power in adjusted analyses
Lack of PESI and sPESI scores for risk stratification
Treatment strategies and long-term outcomes were not evaluated
Frailty was not systematically assessed
Retrospective, single-center observational study with a relatively small sample size
Small number of mortality events reducing statistical power of adjusted analyses
Lack of established risk stratification tools like PESI and sPESI
Treatment strategies and long-term outcomes (recurrence, readmission, late mortality) were not evaluated

Implication

Should not yet alter age-based risk stratification in acute PE; leaves open whether age ≥75 independently predicts mortality after adjustment.

Abstract

Amaç: Pulmoner emboli (PE), özellikle yaşlı gruplarda morbidite ve mortalitenin önemli bir nedenidir. Bu çalışmada, yaşın hastalık seyrine etkisini incelemek için 65 yaş ve üzeri PE hastalarının klinik, demografik ve laboratuvar bulguları karşılaştırılmıştır. Materiyal- metodlar: Bu retrospektif gözlem çalışması, PE tanısı ile hastaneye yatırılan 188 hastayı içermektedir. Hastaların demografik özellikleri, komorbiditeleri, laboratuvar parametreleri, ekokardiyografi bulguları ve klinik seyri hastane kayıtlarından elde edilmiştir. Hastalar yaş gruplarına göre karşılaştırılmıştır: 65-75 yaş ve ≥75 yaş. Bulgular: Tüm grubun ortalama yaşı 72,6±7,14 idi, bunların %52,7'si erkek ve 41'i (%21,8) 75 yaşın üzerindeydi. En sık görülen semptom nefes darlığı (%93,6) idi ve DVT (%13,9) 75 yaşın üzerindeki hastalarda daha sık görüldü. D-dimer, pro-beyin natriüretik peptid (pro-BNP) ve troponin düzeyleri yaşlı grupta anlamlı olarak daha yüksekti. Ekokardiyografide sağ kalp dilatasyonu oranı ≥75 yaş grubunda daha sık görüldü (%36,1'e karşı %3,4, p<0,001). Yoğun bakım ihtiyacı, hastanede kalış süresi ve yoğun bakımda kalış süresi 75 yaşın üzerindeki hastalarda anlamlı olarak daha yüksekti (sırasıyla p<0,001, p=0,016, p<0,001). Mortalite oranı da yaşlı grupta daha yüksekti (12,2% vs. 3,4%, p=0,042). Sonuç: Kardiyak stres belirteçleri, PE' li yaşlı hastalarda önemli ölçüde daha yüksektir ve bu durum, sağ kalp yükünün artması, hastanede kalış süresinin uzaması ve mortalite ile ilişkilidir. Erken tanı, yakın hemodinamik izleme ve multidisipliner yaklaşım, 75 yaş ve üzeri PE hastalarında mortaliteyi azaltmada kritik öneme sahiptir.

Discussion

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Cite This Study

Külah et al. (2026) conducted an observational in Acute Pulmonary Embolism (n=188). Age ≥75 years vs. Age 65-75 years was evaluated on In-hospital mortality (OR 3.944, 95% CI 1.083-14.364, p=0.037). Age ≥75 years was associated with higher unadjusted in-hospital mortality than age 65-75 years in acute pulmonary embolism (12.2% vs 3.4%), but was not an independent predictor after adjustment.

synapsesocial.com/papers/6a93f14b6c1a8fb52e79e30d https://doi.org/10.35514/mtd.2026.144

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Effect Clinical Characteristics and Outcomes of Acute Pulmonary Embolism in Older Adults: A Comparison of Patients Aged 65–75 Years and ≥75 Years

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Effect Clinical Characteristics and Outcomes of Acute Pulmonary Embolism in Older Adults: A Comparison of Patients Aged 65–75 Years and ≥75 Years

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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