Pulmonary embolism and gender: an observational study

Pulmonary Embolism (PE) is a major cause of mortality, morbidity and hospitalization in Europe. Few studies have highlighted sex differences in PE, in particular with regard to hospitalization, outcomes, treatment, complication and mortality.The aim of this study is to analyze the gender differences in patients hospitalized with a principal diagnosis of  E. This is a retrospective population-based cohort study. Data for all patients discharged with a principal diagnosis of PE (ICD-9 415.1) by Apulian hospitals between 2010 and 2016 were retrieved from the National Hospital Discharge Register Database.4,795 patients were discharged with a principal diagnosis of PE during the inclusion period. The majority of which were females (2,762; 57.6%). Mean age was significantly higher in women (73.0 vs 67.9, p < 0.001). Females showed a higher prevalence of hypertensive heart disease (41.1% vs 32.9%, p < 0.001), arrhythmia (16.3% vs 13.9%, p = 0.023), diabetes mellitus (14.8% vs 11.7%, p = 0.002) and obesity (6.6% vs 3.5%, p < 0.001) and a lower prevalence of chronic obstructive pulmonary disease (10.0% vs 18.0, p < 0.001), lung failure (11.1% vs 13.7%, p = 0.006) and cancer (15.3% vs 22.9%, p < 0.001). The overall incidence rate (F: 17.4 vs M: 13.8; AR = +3.6; p < 0.001) and the overall mortality rate (F: 1.3 vs M: 0.9; AR = +0.3; p < 0.001) were higher in women compared to men. The overall case fatality rate was not different between women and men (F: 6.4 vs M: 6.4; AR = 0.0; p = 0.92).Findings from our study showed significant sex disparities for age of hospitalization, comorbidities distribution, incidence and mortality, but no differences in the fatality of the disease. Further studies are needed to identify the determinants and consequences of the gender differences in PE.