Sex-specific differences and risk factors for 30-day mortality in acute pulmonary embolism – results from the Serbian University Multicenter Pulmonary Embolism registry

Jovan Matijašević; Milica Mirić; Jadranka Vučićević Trobok; Sandra Peković; Ilija Andrijević; Boris Džudović; Bojana Subotić; Slobodan Obradović

doi:10.2298/VSP200830048M

Jovan Matijašević Institute for Pulmonary Diseases of Vojvodina, Emergency Pulmonology Clinic, Sremska Kamenica
Milica Mirić Institute for Pulmonary Diseases of Vojvodina, Emergency Pulmonology Clinic, Sremska Kamenica
Jadranka Vučićević Trobok Institute for Pulmonary Diseases of Vojvodina, Emergency Pulmonology Clinic, Sremska Kamenica
Sandra Peković Institute for Pulmonary Diseases of Vojvodina, Emergency Pulmonology Clinic, Sremska Kamenica
Ilija Andrijević Institute for Pulmonary Diseases of Vojvodina, Emergency Pulmonology Clinic, Sremska Kamenica
Boris Džudović Military Medical Academy, Clinic of Cardiology and Internal and Emergency Medicine, Belgrade
Bojana Subotić Military Medical Academy, Clinic of Cardiology and Internal and Emergency Medicine, Belgrade
Slobodan Obradović Military Medical Academy, Clinic of Cardiology and Internal and Emergency Medicine, Belgrade

DOI: https://doi.org/10.2298/VSP200830048M

Keywords: age factors;, coronary disease;, immobilization;, mortality;, pulmonary disease, chronic obstructive;, pulmonary embolism;, risk factors;, sex factors;, tachycardia

Abstract

Background/Aim. The prediction role of gender in early mortality in patients with acute pulmonary embolism (PE) is still debatable. The aim of the study was to examine sex-specific factors in all-cause 30-day mortality in patients suffering from acute PE. Methods. Acute PE subjects (n = 532), 49.6% men, were derived from a “real-life” observational multicenter study. We assessed independent risk factors as predictors for early (one-month) fatal outcome in men, women and total population using univariate Cox regression analysis. Results. Age, obesity, hypertension, renal dysfunction, anemia, community-acquired pneumonia, and smoking history presented statistically significant sex-specific differences. One-month mortality was 13.7%, without significant difference in survival based on sex (Log Rank test; p = 0.324). Tachycardia at admission [hazard ratio (HR) = 2.61, p = 0.004], coronary artery disease (HR = 2.30, p = 0.047), immobilization four weeks prior to a PE episode (HR = 2.31, p = 0.018) and older age (HR = 1.03, p = 0.017) in women, while chronic obstructive pulmonary disease (COPD) (HR = 4.03, p < 0.001) and leukocytosis (HR = 1.19, p < 0.001) in men significantly increased one-month mortality risk. Conclusion. Patient's sex did not prove to be the independent predictor for 30-day mortality in PE patients. We found that tachycardia at admission, older age, coronary artery disease and limb immobilization four weeks prior to PE in women, whereas COPD and elevated leukocyte count in men were associated with higher chance of all-cause early mortality.

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