Sex-Related Differences in Patient Characteristics, Risk Factors, and Symptomatology in Older Adults with Pulmonary Embolism: Findings from the SERIOUS-PE Study - Archive ouverte HAL
Article Dans Une Revue Seminars in Thrombosis and Hemostasis Année : 2023

Sex-Related Differences in Patient Characteristics, Risk Factors, and Symptomatology in Older Adults with Pulmonary Embolism: Findings from the SERIOUS-PE Study

Alfonso Muriel
  • Fonction : Auteur
Yun Wang
  • Fonction : Auteur
Gregory Piazza
  • Fonction : Auteur
Candrika Khairani
  • Fonction : Auteur
Rachel Rosovsky
  • Fonction : Auteur
Ghazaleh Mehdipoor
  • Fonction : Auteur
Michelle O'Donoghue
  • Fonction : Auteur
Olga Madridano
  • Fonction : Auteur
Juan Bosco Lopez-Saez
  • Fonction : Auteur
Meritxell Mellado
  • Fonction : Auteur
Ana Maria Diaz Brasero
  • Fonction : Auteur
Elvira Grandone
  • Fonction : Auteur
Primavera Spagnolo
  • Fonction : Auteur
Yuan Lu
  • Fonction : Auteur
Luciano López-Jiménez
  • Fonction : Auteur
Manuel Jesús Núñez
  • Fonction : Auteur
Ángeles Blanco-Molina
  • Fonction : Auteur
Marie Gerhard-Herman
  • Fonction : Auteur
Samuel Goldhaber
  • Fonction : Auteur
Shannon Bates
  • Fonction : Auteur
David Jimenez
  • Fonction : Auteur
Harlan Krumholz
  • Fonction : Auteur
Manuel Monreal
  • Fonction : Auteur

Résumé

Abstract Sex-specific factors are implicated in pulmonary embolism (PE) presentation in young patients, as indicated by increased risk in pregnancy. Whether sex differences exist in PE presentation, comorbidities, and symptomatology in older adults, the age group in which most PEs occur, remains unknown. We identified older adults (aged ≥65 years) with PE in a large international PE registry replete with information about relevant clinical characteristics (RIETE registry, 2001–2021). To provide national data from the United States, we assessed sex differences in clinical characteristics and risk factors of Medicare beneficiaries with PE (2001–2019). The majority of older adults with PE in RIETE (19,294/33,462, 57.7%) and in the Medicare database (551,492/948,823, 58.7%) were women. Compared with men, women with PE less frequently had atherosclerotic diseases, lung disease, cancer, or unprovoked PE, but more frequently had varicose veins, depression, prolonged immobility, or history of hormonal therapy (p < 0.001 for all). Women less often presented with chest pain (37.3 vs. 40.6%) or hemoptysis (2.4 vs. 5.6%) but more often with dyspnea (84.6 vs. 80.9%) (p < 0.001 for all). Measures of clot burden, PE risk stratification, and use of imaging modalities were comparable between women and men. PE is more common in elderly women than in men. Cancer and cardiovascular disease are more common in men, whereas transient provoking factors including trauma, immobility, or hormone therapy are more common in elderly women with PE. Whether such differences correlate with disparities in treatment or differences in short- or long-term clinical outcomes warrants further investigation.
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Dates et versions

hal-04498580 , version 1 (11-03-2024)

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Behnood Bikdeli, Alfonso Muriel, Yun Wang, Gregory Piazza, Candrika Khairani, et al.. Sex-Related Differences in Patient Characteristics, Risk Factors, and Symptomatology in Older Adults with Pulmonary Embolism: Findings from the SERIOUS-PE Study. Seminars in Thrombosis and Hemostasis, 2023, 49 (07), pp.725-735. ⟨10.1055/s-0043-1764231⟩. ⟨hal-04498580⟩
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