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Dzudovic B, Subotic B, Novicic N, Matijasevic J, Trobok J, Miric M, Salinger-Martinovic S, Stanojevic D, Nikolic M, Miloradovic V, Markovic Nikolic N, Dekleva M, Lepojevic Stefanovic D, Kos L, Kovacevic Preradovic T, Obradovic S. Sex-related difference in the prognostic value of syncope for 30-day mortality among hospitalized pulmonary embolism patients. Clin Respir J 2020; 14:645-651. [PMID: 32129009 DOI: 10.1111/crj.13179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 01/19/2020] [Accepted: 02/23/2020] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Recent studies report that syncope is not a significant predictor of 30-day mortality in pulmonary embolism (PE) patients, yet some data suggest sex-related differences may be relevant. OBJECTIVES To evaluate sex-specific prediction significance of syncope for 30-day mortality in PE patients. METHODS A multicentric, retrospective, observational, registry-based study on consecutive PE patients was undertaken. Patients were allocated into either a men or a women group before comparisons were made between patients with syncope and those without syncope. A sex-related prediction of the significance of syncope for 30-day mortality was evaluated. RESULTS Overall 588 patients [294 (50%) men and 294 (50%) women] were included within the study. Among men, patients with syncope were older and had significantly higher parameters of increased 30-day mortality then patients without syncope. Within the same group, however, difference in the 30-day mortality rate was not significant (log rank P = .942). In contrast to the men, fewer differences in admission characteristics were noticed among women, but those with syncope had significantly increased signs of the right ventricular dysfunction and increased 30-day mortality rate, as compared with those without syncope (log rank P = .025). After adjustment for age in a Cox regression analysis, syncope was a significant predictor of 30-day mortality in women (HR = 2.01, 95%CI 1.02-3.95). CONCLUSION Although syncope is associated with other predictors of higher early mortality in both male and female PE patients, only in women it is a significant predictor of 30-day mortality.
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Affiliation(s)
- Boris Dzudovic
- Clinic for Cardiology and Emergency Internal Medicine, Military Medical Academy, School of Medicine, University of Defense, Belgrade, Serbia
| | - Bojana Subotic
- Clinic for Cardiology and Emergency Internal Medicine, Military Medical Academy, School of Medicine, University of Defense, Belgrade, Serbia
| | - Natasa Novicic
- Clinic for Cardiology and Emergency Internal Medicine, Military Medical Academy, School of Medicine, University of Defense, Belgrade, Serbia
| | - Jovan Matijasevic
- Institute for Pulmonary Diseases of Vojvodina, Clinic for Pulmonary Oncology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Jadranka Trobok
- Institute for Pulmonary Diseases of Vojvodina, Clinic for Pulmonary Oncology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Milica Miric
- Institute for Pulmonary Diseases of Vojvodina, Clinic for Pulmonary Oncology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | | | - Dragana Stanojevic
- Clinic for Cardiology, Clinical Center Nis, School of Medicine, University of Nis, Serbia
| | - Maja Nikolic
- Clinic for Cardiology, School of Medicine, University of Kragujevac, Serbia
| | | | | | - Milica Dekleva
- Zvezdara University Medical Center, School of Medicine, University of Belgrade, Serbia
| | | | - Ljiljana Kos
- Clinic for Cardiology, Clinical Center Banja Luka, School of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
| | - Tamara Kovacevic Preradovic
- Clinic for Cardiology, Clinical Center Banja Luka, School of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
| | - Slobodan Obradovic
- Clinic for Cardiology and Emergency Internal Medicine, Military Medical Academy, School of Medicine, University of Defense, Belgrade, Serbia
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