Tian Han, Zhang Yu, Liu JiXiang, Yang Yuanhua, Ji Yingqun, Chen Hong, Wang Dingyi, Zhang Zhu, Yi Qun, Dong Chunling, Xu Xiaomao, Hu Xiaoyun, Mao Yimin, Zhu Ling, Liu Zhihong, Shi Juhong, Deng Chaosheng, Cheng Zhe, Zhang Yunxia, Zhang Meng, Pang Wenyi, Lei Jieping, Wu Sinan, Tao Yuzhi, Xi Linfeng, Gao Qian, Zhang Shuai, Si Chaozeng, Xia Lei, Liu Min, Li Aili, Sun Yihong, Huang Qiang, Xie Wanmu, Wan Jun, Yang Peiran, Wang Shengfeng, Wang Chen, Zhai Zhenguo
China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, China; National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.
National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; China-Japan Friendship Hospital, Capital Medical University, Beijing, China.
Thromb Res. 2024 Nov;243:109146. doi: 10.1016/j.thromres.2024.109146. Epub 2024 Sep 6.
Pulmonary embolism (PE) is a common and potentially fatal disease, with differences in mortality rates among PE patients of different sexes. This study aims to investigate the disparities in clinical manifestations and in-hospital mortality rates between sexes in PE patients, as well as the association of clinical symptoms with in-hospital mortality.
We analyzed data from the China pUlmonary thromboembolism REgistry Study (CURES), a nationwide, multicenter, prospective registry focusing on patients with acute PE. Using propensity score matching (PSM) to pair male and female patients with PE, we explored the correlation between clinical symptoms and in-hospital mortality through multivariable regression analysis.
A total of 15,203 patients with acute PE were enrolled, and 380 died during hospitalization. The incidence of chest pain, hemoptysis, and palpitations was significantly higher in males compared to females. The incidence of dyspnea, fever, and syncope was higher in females. Hemoptysis and dyspnea were associated with increased in-hospital mortality in males, whereas dyspnea, fever, and palpitations were linked to higher mortality in females. Overall, males exhibited a higher in-hospital mortality than females (2.9 % vs. 2.1 %, p = 0.002). After matching 13,130 patients using the PSM method, the mortality rate of males remained higher than that of females (2.7 % vs. 2.1 %, p = 0.020).
Our study demonstrates that male patients with PE have a higher risk of in-hospital mortality than females. Significant differences in clinical symptoms between sexes are associated with increased mortality risk, emphasizing the need for clinical awareness.
肺栓塞（PE）是一种常见且可能致命的疾病，不同性别的PE患者死亡率存在差异。本研究旨在探讨PE患者性别之间临床表现和住院死亡率的差异，以及临床症状与住院死亡率的关联。
我们分析了来自中国肺血栓栓塞症注册研究（CURES）的数据，这是一项全国性、多中心、前瞻性注册研究，聚焦于急性PE患者。使用倾向评分匹配（PSM）方法对男性和女性PE患者进行配对，通过多变量回归分析探讨临床症状与住院死亡率之间的相关性。
共纳入15203例急性PE患者，其中380例在住院期间死亡。男性胸痛、咯血和心悸的发生率显著高于女性。女性呼吸困难、发热和晕厥的发生率较高。咯血和呼吸困难与男性住院死亡率增加相关，而呼吸困难、发热和心悸与女性较高的死亡率相关。总体而言，男性的住院死亡率高于女性（2.9%对2.1%，p = 0.002）。使用PSM方法匹配13130例患者后，男性的死亡率仍高于女性（2.7%对2.1%，p = 0.020）。
我们的研究表明，PE男性患者的住院死亡风险高于女性。性别之间临床症状的显著差异与死亡风险增加相关，强调了临床意识的必要性。
