Sex-Based Differences in Clinical Characteristics and Outcomes in Patients with Acute Pulmonary Embolism. An Analysis of 1000 Pulmonary Embolism Response Team Activations

Introduction: Pulmonary embolism (PE) is a leading cause of cardiovascular death, with prior studies suggesting differences in clinical characteristics and risk factors between males and females. Methods: We retrospectively analyzed all 1,000 adult patients with confirmed PE evaluated by the Pulmonary Embolism Response Team (PERT) at Corewell Health West from November 2019 to March 2024 to describe sex-based differences in presentation, management, and outcomes. Based on sex, patients were classified by differences in demographic, clinical, biomarker, treatment, and outcome measures, including 30-day and one-year survival. Results: Among 1,000 patients, 480 (48%) were female. Females were older (64 vs. 62.4 years; p = 0.028), had higher body mass index (35.5 vs. 32.2; p < 0.001), and more frequently reported hormone use (21% vs. 5%; p < 0.001). Troponin and Pro-BNP elevations were higher in proportion in females, while males were more likely to smoke (26% vs. 15%; p < 0.001) and present with cough (31% vs. 23%; p = 0.005). No significant sex differences were observed in PE severity, catheter-based interventions, inferior vena cava filter placement, or 30-day (females 8.7%, males 5.8%; p = 0.064) and one-year survival (females 85.4%, males 87.9%; p = 0.217). Conclusion: Despite differences in baseline characteristics and certain clinical features, PE severity, interventions, and outcomes were similar between sexes in this PERT-managed cohort. This highlights sex-specific variations in presentation without differences in management or outcomes within a standardized multidisciplinary pathway such as PERT.