Abstract 13801: Gender Disparity in Clinical and Management Outcomes in Patients With Pulmonary Embolism: A Systematic Review and Meta-Analysis

Introduction: Gender is a unique characteristic that may contribute significant variation in prognostic aspects and outcomes to various clinical conditions. We aim to compile all evidence from original studies relevant to sex-based disparities in pulmonary embolism (PE) associated clinical outcomes.

Methods: We conducted a systematic review and meta-analysis synthesizing observational comparative studies, which were retrieved by systematically searching: PubMed, Web of Science, SCOPUS, and Cochrane through April 12 ^th , 2023. We reported dichotomous outcomes using risk ratio (RR) along with the corresponding 95% confidence interval (CI).

Results: We included 18 studies with a total of 1,339,937 patients. There was no difference between men and women regarding all-cause mortality (RR: 0.99 with 95% CI [0.89, 1.10], P = 0.81), in-hospital mortality (RR: 0.94 with 95% CI [0.88, 1.02], P = 0.13), PE-related mortality (RR: 0.86 with 95% CI [0.68, 1.09], P = 0.21), and recurrence (RR: 1.00 with 95% CI [0.82, 1.22], P = 0.99). However, the major bleeding rate was significantly higher among women (RR: 0.69 with 95% CI [0.48, 0.98], P= 0.04). Also, there was no difference between men and women regarding catheter thrombolysis (RR: 0.96 with 95% CI [0.81, 1.14], P= 0.66) and heparin infusion (RR: 1.00 with 95% CI [0.95, 1.04], P= 0.90).

Conclusion: There was no difference between men and women regarding clinical and management of PE outcomes, with a trend towards worse outcomes and decreased interventions among women, with a significant increase in major bleeding. Further policy measures are required to investigate the reasons behind this trend and if it has any clinically significant impact on patients' management and prognosis.