Department of Medicine.
Division of Cardiology, Department of Medicine.
Am J Cardiol. 2023 Sep 1;202:67-73. doi: 10.1016/j.amjcard.2023.06.012. Epub 2023 Jul 7.
Pulmonary embolism (PE) is the third most common cause of cardiovascular death; however, gender disparities in PE remain understudied. All PE cases at a single institution between January 2013 and June 2019 were retrospectively reviewed. The clinical presentation, treatment modalities, and outcomes were compared between men and women using univariate and multivariate analyses adjusting for differences in baseline characteristics. A total of 1,345 patients were diagnosed with acute PE, of whom 56.3% were women (n = 757). Women had a significantly higher mean body mass index (29.4 vs 28.4) and a higher frequency of hypertension (53% vs 46%) and hormone use (6.6% vs 0%; all p <0.02). Men had a higher frequency of smoking (45% vs 33%, p <0.0001). Women had significantly lower PE severity index classifications (p = 0.0009). The rates of intensive care unit admission, vasopressor requirements, extracorporeal membrane oxygenation cannulation, and mechanical ventilation were similar between the genders. There was no significant difference in the treatment modality used between the genders. Although the risk factors and PE severity index class differed between the genders, there was no significant difference in resource utilization or treatment modality. Gender was also not a significant predictor of in-hospital mortality, moderate or severe bleeding, increased length of stay, or readmission in the study population.
肺栓塞(PE)是心血管死亡的第三大常见原因;然而,PE 中的性别差异仍研究不足。回顾了 2013 年 1 月至 2019 年 6 月期间单一机构的所有 PE 病例。使用单变量和多变量分析比较了男性和女性之间的临床表现、治疗方式和结局,并对基线特征的差异进行了调整。共有 1345 例患者被诊断为急性 PE,其中 56.3%为女性(n=757)。女性的平均体重指数明显更高(29.4 对 28.4),高血压(53%对 46%)和激素使用(6.6%对 0%;均 p<0.02)的频率更高。男性吸烟的频率更高(45%对 33%,p<0.0001)。女性的 PE 严重指数分类明显较低(p=0.0009)。男女入住重症监护病房、使用升压药、体外膜氧合插管和机械通气的比例相似。男女之间使用的治疗方式没有显著差异。尽管性别之间的危险因素和 PE 严重指数分类不同,但资源利用或治疗方式没有显著差异。性别也不是研究人群住院死亡率、中度或重度出血、住院时间延长或再入院的显著预测因素。