Sex‐related difference in the prognostic value of syncope for 30‐day mortality among hospitalized pulmonary embolism patients

Džudović, Boris; Subotić, Bojana; Novicic, Natasa; Matijašević, Jovan; Jadranka, Trobok; Mirić, Milica; Salinger‐Martinovic, Sonja; Stanojević, Dragana; Nikolić, Maja; Miloradović, Vladimir; Markovic-Nikolic, Natasa; Dekleva, Milica; Stefanović, Danijela; Kos, Ljiljana; Preradović, Tamara Kovačević; Obradović, Slobodan

doi:10.1111/crj.13179

Cited by 3 publications

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“… 27 28 However, syncope at presentation may only be associated with early death in women. 29 Syncope may be due to the passage of a thrombus through the right ventricle, causing transient arrhythmia, or the presence of a large thrombus in the main pulmonary arteries or right ventricle, causing an obstruction of blood flow with a sudden decrease in arterial pressure or activation of the vaso-vagal reflex. 30 The first mechanism may be responsible for syncope in patients with low-risk PE.…”

Section: Discussionmentioning

confidence: 99%

“…The presence of syncope is considered a feature of severe PE, and patients with syncope and acute PE usually present with haemodynamic instability and right ventricle dysfunction and have adverse short-term outcomes 27 28. However, syncope at presentation may only be associated with early death in women 29. Syncope may be due to the passage of a thrombus through the right ventricle, causing transient arrhythmia, or the presence of a large thrombus in the main pulmonary arteries or right ventricle, causing an obstruction of blood flow with a sudden decrease in arterial pressure or activation of the vaso-vagal reflex 30.…”

Section: Discussionmentioning

confidence: 99%

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Signs and symptoms of acute pulmonary embolism and their predictive value for all-cause hospital death in respect of severity of the disease, age, sex and body mass index: retrospective analysis of the Regional PE Registry (REPER)

et al. 2023

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BackgroundThe incidence of the signs and symptoms of acute pulmonary embolism (PE) according to mortality risk, age and sex has been partly explored.Patients and methodsA total of 1242 patients diagnosed with acute PE and included in the Regional Pulmonary Embolism Registry were enrolled in the study. Patients were classified as low risk, intermediate risk or high risk according to the European Society of Cardiology mortality risk model. The incidence of the signs and symptoms of acute PE at presentation with respect to sex, age, and PE severity was investigated.ResultsThe incidence of haemoptysis was higher in younger men with intermediate-risk (11.7% vs 7.5% vs 5.9% vs 2.3%; p=0.01) and high-risk PE (13.8% vs 2.5% vs 0.0% vs 3.1%; p=0.031) than in older men and women. The frequency of symptomatic deep vein thrombosis was not significantly different between subgroups. Older women with low-risk PE presented with chest pain less commonly (35.8% vs 55.8% vs 48.8% vs 51.9%, respectively; p=0.023) than men and younger women. However, younger women had a higher incidence of chest pain in the lower-risk PE group than in the intermediate-risk and high-risk PE subgroups (51.9%, 31.4% and 27.8%, respectively; p=0.001). The incidence of dyspnoea (except in older men), syncope and tachycardia increased with the risk of PE in all subgroups (p<0.01). In the low-risk PE group, syncope was present more often in older men and women than in younger patients (15.5% vs 11.3% vs 4.5% vs 4.5%; p=0.009). The incidence of pneumonia was higher in younger men with low-risk PE (31.8% vs<16% in the other subgroups, p<0.001).ConclusionHaemoptysis and pneumonia are prominent features of acute PE in younger men, whereas older patients more frequently have syncope with low-risk PE. Dyspnoea, syncope and tachycardia are symptoms of high-risk PE irrespective of sex and age.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Signs and symptoms of acute pulmonary embolism and their predictive value for all-cause hospital death in respect of severity of the disease, age, sex and body mass index: retrospective analysis of the Regional PE Registry (REPER)

et al. 2023

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“…In addition, laboratory tests in patients with syncope showed higher levels of D-dimer and troponin T, and RVD was more pronounced in women with syncope. Dzudovic et al (2020) also proposed that the increased mortality of high-risk PE patients with syncope was caused by RVD and hemodynamic instability, while the mortality of sick people with low and medium risk of PE was not significantly increased (Mohebali et al, 2020). There was no significant association between syncope and prognosis or mortality in patients with hemodynamically stable pulmonary embolism (Barco et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

A new machine learning model for predicting severity prognosis in patients with pulmonary embolism: Study protocol from Wenzhou, China

Shou

et al. 2022

Front. Neuroinform.

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IntroductionPulmonary embolism (PE) is a common thrombotic disease and potentially deadly cardiovascular disorder. The ratio of clinical misdiagnosis and missed diagnosis of PE is very large because patients with PE are asymptomatic or non-specific.MethodsUsing the clinical data from the First Affiliated Hospital of Wenzhou Medical University (Wenzhou, China), we proposed a swarm intelligence algorithm-based kernel extreme learning machine model (SSACS-KELM) to recognize and discriminate the severity of the PE by patient’s basic information and serum biomarkers. First, an enhanced method (SSACS) is presented by combining the salp swarm algorithm (SSA) with the cuckoo search (CS). Then, the SSACS algorithm is introduced into the KELM classifier to propose the SSACS-KELM model to improve the accuracy and stability of the traditional classifier.ResultsIn the experiments, the benchmark optimization performance of SSACS is confirmed by comparing SSACS with five original classical methods and five high-performance improved algorithms through benchmark function experiments. Then, the overall adaptability and accuracy of the SSACS-KELM model are tested using eight public data sets. Further, to highlight the superiority of SSACS-KELM on PE datasets, this paper conducts comparison experiments with other classical classifiers, swarm intelligence algorithms, and feature selection approaches.DiscussionThe experimental results show that high D-dimer concentration, hypoalbuminemia, and other indicators are important for the diagnosis of PE. The classification results showed that the accuracy of the prediction model was 99.33%. It is expected to be a new and accurate method to distinguish the severity of PE.

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Sex-Based Differences in the Presentation and Outcomes of Acute Pulmonary Embolism: A Systematic Review and Meta-Analysis

Luo

et al. 2023

Texas Heart Institute Journal

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Background The study aimed to review differences in the presentation and outcomes of acute pulmonary embolism (PE) between men and women. Methods PubMed, CENTRAL, Web of Science, and Embase were searched for studies comparing clinical features or outcomes of PE between men and women. Baseline comorbidities, risk factors, clinical features, and mortality rates were also compared between men and women. Results Fourteen studies were included. It was noted that men presented with PE at a statistically significantly younger age than women (P < .001). Smoking history (P < .001), lung disease (P = .004), malignancy (P = .02), and unprovoked PE (P = .004) were significantly more frequent among men than among women. There was no difference between the sexes for hypertension, diabetes, and a history of recent immobilization. A significantly higher proportion of men presented with chest pain (P = .02) and hemoptysis (P < .001), whereas syncope (P = .005) was more frequent in women. Compared with men, women had a higher proportion of high-risk PE (P = .003). There was no difference in the use of thrombolytic therapy or inferior vena cava filter. Neither crude nor adjusted mortality rates were significantly different between men and women. Conclusion This review found that the age at presentation, comorbidities, and symptoms of PE differed between men and women. Limited data also suggest that women more frequently had high-risk PE compared with men, but the use of thrombolytic therapy did not differ between the 2 sexes. Importantly, both crude and adjusted data show that the mortality rate did not differ between men and women.

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Sex‐related difference in the prognostic value of syncope for 30‐day mortality among hospitalized pulmonary embolism patients

Cited by 3 publications

References 18 publications

Signs and symptoms of acute pulmonary embolism and their predictive value for all-cause hospital death in respect of severity of the disease, age, sex and body mass index: retrospective analysis of the Regional PE Registry (REPER)

Signs and symptoms of acute pulmonary embolism and their predictive value for all-cause hospital death in respect of severity of the disease, age, sex and body mass index: retrospective analysis of the Regional PE Registry (REPER)

A new machine learning model for predicting severity prognosis in patients with pulmonary embolism: Study protocol from Wenzhou, China

Sex-Based Differences in the Presentation and Outcomes of Acute Pulmonary Embolism: A Systematic Review and Meta-Analysis

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