Female patients with high-risk pulmonary embolism had 22% higher adjusted odds of mortality despite 17% higher odds of receiving systemic thrombolysis compared to males.
Do female patients with high-risk pulmonary embolism experience different management strategies and clinical outcomes compared to male patients?
In high-risk pulmonary embolism, female patients face significantly higher mortality and MACCE rates than males, alongside disparities in the utilization of advanced therapies such as catheter-directed or surgical embolectomy.
Absolute Event Rate: 0% vs 0%
Abstract Background Pulmonary embolism (PE) remains a significant cause of cardiovascular morbidity and mortality. Despite advancements in diagnosis and treatment, gender disparities in high-risk PE management and outcomes remain poorly understood. This study aimed to investigate gender-based differences in the presentation, treatment, and outcomes of patients with high-risk PE. Methods We analyzed data from the National Inpatient Sample for patients with high-risk PE from 2016 to 2021. High-risk PE was defined as PE with cardiogenic shock, mechanical ventilation, mechanical circulatory support, or vasopressors. Multivariable logistic regression was used to examine gender-based differences in management and outcomes. Results Of 45,140 patients with high-risk PE, 51.4% were female. Female patients were older (mean age 65.2 vs. 63.4 years, p0.001) and more likely to present with cardiac arrest (35.4% vs. 30.4%, p0.001). After adjustment, females were more likely to receive systemic thrombolysis (aOR 1.17, 95% CI 1.11-1.23, p0.001) but less likely to undergo catheter-directed embolectomy (aOR 0.92, 95% CI 0.86-0.99, p=0.034) or surgical embolectomy/thrombectomy (aOR 0.83, 95% CI 0.73-0.93, p=0.002). Female patients experienced higher rates of all-cause mortality (aOR 1.22, 95% CI 1.18-1.27, p0.001) and major adverse cardiovascular and cerebrovascular events (aOR 1.21, 95% CI 1.16-1.25, p0.001). Conclusion Significant gender disparities exist in the management and outcomes of high-risk PE. Female patients have higher mortality rates despite being more likely to receive systemic thrombolysis. Further research is needed to understand and address these disparities to improve outcomes for all patients with high-risk PE.Figure 2 Table 2
Folman et al. (Sat,) reported a other. Female patients with high-risk pulmonary embolism had 22% higher adjusted odds of mortality despite 17% higher odds of receiving systemic thrombolysis compared to males.