Percutaneous Thrombectomy Outcomes in Female vs Male Patients With PE

There is a higher risk for in-hospital mortality and morbidity in female vs male patients with pulmonary embolism (PE) undergoing percutaneous thrombectomy, according to study findings published in CHEST.

Athough research has found that female patients hospitalized for PE have worse outcomes than male patients, evidence is lacking on sex-based outcome differences associated with interventional therapies for PE. Researchers therefore assessed outcome differences between male and female patients with PE undergoing percutaneous thrombectomy.

The researchers conducted a retrospective cross-sectional study using US national inpatient claims data collected between 2016 and 2018 on patients with a discharge diagnosis of PE who also underwent a percutaneous thrombectomy. Data for a total of 5160 adult patients, including 2520 female patients and 2640 male patients, were included in the study. A multivariable regression model with female patients as a categorical variable was used to evaluate the association between PE diagnosis and various outcomes, with in-hospital death as the primary outcome. The investigators’ analyses also took into account demographic variables, comorbidities, discharge to home, hospital length of stay, and health care resource utilization.

The investigators found a higher incidence of various adverse outcomes in female patients vs male patients, including more perioperative bleeding (16.9% vs 11.2%; P <.05), more blood transfusions (11.9% vs 5.7%; P <.05), and more vascular complications (5.0% vs 1.5%; P <.05). In-hospital mortality was also higher for female vs male patients (16.9% vs 9.3%, respectively; adjusted odds ratio [aOR], 1.9; 95% CI, 1.2-3.0; P =.003).

Length of stay and health care resource utilization was found to be similar for male and female patients, although female patients were less likely than male patients to be discharged home (47.9% vs 60.3%, respectively; aOR. 0.7; 95% CI, 0.50-0.99; P =.04) and instead required further outpatient care.

Study limitations include the inability to assess the severity of PE; lack of anticoagulation pharmacotherapeutic details; inability to distinguish between comorbidities and in-hospital complications; and missing data.

“Our data suggest that female patients undergoing percutaneous pulmonary artery thrombectomy represent a particularly vulnerable patient population,” concluded the researchers. Further studies are required to validate and determine the causes, they added.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 

Reference

Agarwal MA, Dhaliwal JS, Yang EH, et al. Sex differences in outcomes of percutaneous pulmonary artery thrombectomy in patients with pulmonary embolism. Chest. Published online August 1, 2022. doi:10.1016/j.chest.2022.07.020