Bansal Mridul, Mehta Aryan, Ahmad Khansa, Bortnick Anna E, Nagaraja Vinayak, Hyder Omar N, Dawn Abbott J, Vallabhajosyula Saraschandra
Department of Medicine, East Carolina University Brody School of Medicine, Greenville, North Carolina, USA.
Department of Medicine, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
Catheter Cardiovasc Interv. 2025 Jan;105(1):193-199. doi: 10.1002/ccd.31344. Epub 2024 Dec 10.
There are limited and conflicting data on sex and urban-rural disparities in outcomes of patients with pulmonary embolism (PE) in the reproductive age group. Our object was to assess sex disparities in the reproductive age group cohort. All adult non-elective admissions in the reproductive age group (18-49 years) with a primary diagnosis of PE and with no missing sex/age data were identified using the National Inpatient Sample. Females and males were stratified into rural and urban location based on hospital information. Outcomes of interest included in-hospital mortality, complication rates, variations in management, total hospitalization costs, and length of stay. During 01/01/2016 to 12/31/2020, 180,898 PE admissions aged 18-49 years were identified (rural-12,319 [6.8%]). Females comprised 54.8% and 55.1% of the rural and urban cohorts, respectively. Overall, compared to males, females in urban and rural regions had largely comparable rates of definitive PE interventions, except lower rates of catheter directed therapy (4.7 vs. 3.6%, p < 0.001) in females admitted to urban hospitals. Despite younger age, higher comorbidity, and lower utilization of PE interventions, females in both regions had similar unadjusted in-hospital mortality (rural 1.1% vs. 1.0%; p = 0.93 and urban 1.8% vs. 1.7%; p = 0.78) and hospitalization costs compared to males. In conclusion, females of reproductive age group had comparable in-hospital outcomes to males in both urban and rural areas. Females in urban areas had lower utilization of advanced PE interventions, potentially indicating selective management strategies in different settings.
关于育龄期肺栓塞（PE）患者的结局在性别和城乡差异方面的数据有限且相互矛盾。我们的目的是评估育龄期队列中的性别差异。利用国家住院样本，确定了所有18 - 49岁主要诊断为PE且无缺失性别/年龄数据的成年非择期入院患者。根据医院信息，将女性和男性按城乡位置进行分层。感兴趣的结局包括住院死亡率、并发症发生率、管理差异、总住院费用和住院时间。在2016年1月1日至2020年12月31日期间，确定了180,898例18 - 49岁的PE入院患者（农村12,319例[6.8%]）。女性分别占农村和城市队列的54.8%和55.1%。总体而言，与男性相比，城乡地区的女性在确定性PE干预率方面大致相当，只是城市医院入院的女性导管定向治疗率较低（4.7%对3.6%，p < 0.001）。尽管年龄较小、合并症较多且PE干预利用率较低，但两个地区的女性与男性相比，未调整的住院死亡率（农村1.1%对1.0%；p = 0.93，城市1.8%对1.7%；p = 0.78）和住院费用相似。总之，育龄期女性在城乡地区的住院结局与男性相当。城市地区的女性对先进PE干预的利用率较低，这可能表明在不同环境中有选择性的管理策略。
