Troxler Benjamin, Boesing Maria, Kueng Cedrine, Jaun Fabienne, Leuppi Joerg Daniel, Lüthi-Corridori Giorgia
University Institute of Internal Medicine, Cantonal Hospital Baselland, 4410 Liestal, Switzerland.
Faculty of Medicine, University of Basel, 4056 Basel, Switzerland.
J Clin Med. 2025 Jul 26;14(15):5287. doi: 10.3390/jcm14155287.
: Pulmonary embolism (PE) remains a major cause of morbidity and mortality. Despite advances in care, its nonspecific symptoms pose diagnostic and therapeutic challenges. Emerging evidence suggests sex-based differences in PE presentation, management, and outcomes, yet real-world data from European settings remain scarce. This study aimed to investigate sex differences in clinical presentation, diagnostic workup, therapeutic interventions, and outcomes among hospitalized PE patients. : We conducted a retrospective cohort study including all adult patients (≥18 years) admitted with a main diagnosis of acute PE at the Cantonal Hospital Baselland between January 2018 and December 2020. Data were extracted from electronic medical records and included demographics, comorbidities, symptoms, diagnostics, treatments, and outcomes. Sex-based comparisons were performed using univariate analyses. : Among 197 patients, 54% were women. Compared to men, women were more often admitted by ambulance (42% n = 45 vs. 24% n = 22, = 0.009), had more frequent tachycardia (38% n = 41 vs. 23% n = 21, = 0.024), and received lysis therapy more often (10% n = 11 vs. 2% n = 2, = 0.023). DVT was more frequently diagnosed in women when sonography was performed (82% n = 49 vs. 64% n = 34, = 0.035). Men had higher rates of B symptoms, smoking, and family history of PE. Women had longer hospital stays and were more frequently discharged to rehabilitation facilities. No sex differences were found in in-hospital mortality, 6-month rehospitalization, or adherence to diagnostic guidelines. : This study reveals sex-based differences in PE presentation and management, suggesting potential disparities in care pathways. Further research is needed to promote equitable, personalized treatment strategies.
肺栓塞（PE）仍然是发病和死亡的主要原因。尽管医疗有所进步，但其非特异性症状给诊断和治疗带来了挑战。新出现的证据表明，PE在表现、管理和结果方面存在性别差异，但欧洲地区的真实世界数据仍然匮乏。本研究旨在调查住院PE患者在临床表现、诊断检查、治疗干预和结果方面的性别差异。
我们进行了一项回顾性队列研究，纳入了2018年1月至2020年12月期间在巴塞尔兰州立医院因急性PE为主诊断入院的所有成年患者（≥18岁）。数据从电子病历中提取，包括人口统计学、合并症、症状、诊断、治疗和结果。采用单因素分析进行基于性别的比较。
在197例患者中，54%为女性。与男性相比，女性更常通过救护车入院（42%，n = 45 vs. 24%，n = 22，P = 0.009），心动过速更频繁（38%，n = 41 vs. 23%，n = 21，P = 0.024），接受溶栓治疗的频率更高（10%，n = 11 vs. 2%，n = 2，P = 0.023）。进行超声检查时，女性更常被诊断为深静脉血栓形成（DVT）（82%，n = 49 vs. 64%，n = 34，P = 0.035）。男性的B症状、吸烟率和PE家族史更高。女性住院时间更长，更常出院到康复机构。在住院死亡率、6个月再住院率或遵循诊断指南方面未发现性别差异。
本研究揭示了PE在表现和管理方面的性别差异，提示护理途径可能存在差异。需要进一步研究以促进公平、个性化的治疗策略。
