Background

The sex differences in use, safety outcomes, and health-care resource use of patients with pulmonary embolism (PE) undergoing percutaneous pulmonary artery thrombectomy are not well characterized.

Research Question

What are the sex differences in outcomes for patients diagnosed with PE who undergo percutaneous pulmonary artery thrombectomy?

Study Design and Methods

This retrospective cross-sectional study used national inpatient claims data to identify patients in the United States with a discharge diagnosis of PE who underwent percutaneous thrombectomy between January 2016 and December 2018. We evaluated the demographics, comorbidities, safety outcomes (in-hospital mortality), and health-care resource use (discharge to home, length of stay, and hospital charges) of patients with PE undergoing percutaneous thrombectomy.

Results

Among 1,128,904 patients with a diagnosis of PE between 2016 and 2018, 5,160 patients (0.5%) underwent percutaneous pulmonary artery thrombectomy. When compared with male patients, female patients showed higher procedural bleeding (16.9% vs 11.2%; P < .05), required more blood transfusions (11.9% vs 5.7%; P < .05), and experienced more vascular complications (5.0% vs 1.5%; P < .05). Women experienced higher in-hospital mortality (16.9% vs 9.3%; adjusted OR, 1.9; 95% CI, 1.2-3.0; P = .003) when compared with men. Although length of stay and hospital charges were similar to those of men, women were less likely to be discharged home after surviving hospitalization (47.9% vs 60.3%; adjusted OR, 0.7; 95% CI, 0.50-0.99; P = .04).

Interpretation

In this large nationwide cohort, women with PE who underwent percutaneous thrombectomy showed higher morbidity and in-hospital mortality compared with men.

中文翻译：

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肺栓塞患者经皮肺动脉血栓切除术结果的性别差异

背景

接受经皮肺动脉血栓切除术的肺栓塞 (PE) 患者在使用、安全结果和医疗资源使用方面的性别差异尚未得到很好的表征。

研究问题

接受经皮肺动脉血栓切除术的诊断为 PE 的患者的结局有何性别差异？

研究设计和方法

这项回顾性横断面研究使用全国住院患者索赔数据来确定出院诊断为 PE 并在 2016 年 1 月至 2018 年 12 月期间接受经皮血栓切除术的美国患者。我们评估了人口统计学、合并症、安全性结果（院内死亡率）以及接受经皮血栓切除术的 PE 患者的医疗保健资源使用（出院回家、住院时间和住院费用）。

结果

在 2016 年至 2018 年诊断为 PE 的 1,128,904 名患者中，5,160 名患者 (0.5%) 接受了经皮肺动脉血栓切除术。与男性患者相比，女性患者的手术出血率更高（16.9% vs 11.2%；P  < .05），需要更多的输血（11.9% vs 5.7%；P  < .05），并经历更多的血管并发症（5.0%对比 1.5%；P  < .05）。与男性相比，女性的住院死亡率更高（16.9% 对 9.3%；调整后的 OR，1.9；95% CI，1.2-3.0；P  = .003）。尽管住院时间和住院费用与男性相似，但女性在住院后出院回家的可能性较小（47.9% 对 60.3%；调整后的 OR，0.7；95% CI，0.50-0.99；P =.04）。

解释

在这个全国性的大型队列中，与男性相比，接受经皮血栓切除术的 PE 女性的发病率和院内死亡率更高。