The Influence of Gender in The Prognostic Impact of Diabetes mellitus in acute Pulmonary Embolism

Oliveira, Diana; Brito, Teresa; Elias, Catarina; Carreira, Marta; Serino, Mariana; Guerreiro, I.; Magalhães, Helena; Coelho, Sara; Ferreira, Sara; Araújo, Emanuel; Ribeiro, Ana Freitas; Lourenço, Patrícia

doi:10.3390/jcm9113511

Cited by 3 publications

(3 citation statements)

References 24 publications

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“…These results from Spain (2016–2018) confirmed a former analysis comprising data of >120,000 PE patients in which diabetes was also related to higher in‐hospital mortality (men OR 1.22, 95% CI 1.12–1.32; women OR 1.24, 95% CI 1.15–1.33) 47 . Interestingly, a study of 577 PE patients aiming to investigate sex differences in outcome also showed an elevated mortality of PE patients with diabetes, but after sex‐specific assessment, the association between diabetes and increased mortality among PE patients was attenuated in women who were associated with a doubled risk of death compared with patients without diabetes 48 . In contrast to the aforementioned studies, in a matched retrospective cohort study (RIETI registry) comprising 2,010 diabetes patients with PE who were compared with two age‐ and sex‐matched controls, diabetes was not independently associated with mortality 20 .…”

Section: Discussionmentioning

confidence: 99%

Diabetes mellitus and its impact on mortality rate and outcome in pulmonary embolism

Schmitt

Hobohm

Sivanathan

et al. 2021

J of Diabetes Invest

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Aims/Introduction In patients with pulmonary embolism (PE), the impact of diabetes mellitus on patient profile and outcome is not well investigated. Material and Methods The German nationwide inpatient sample of the years 2005–2018 was analyzed. Hospitalized PE patients were stratified for diabetes, and the impact of diabetes on in‐hospital events was investigated. Results Overall, 1,174,196 PE patients (53.8% aged ≥70 years, 53.5% women) and, among these, 219,550 (18.7%) diabetes patients were included. In‐hospital mortality rate amounted to 15.8%, and was higher in diabetes patients than in non‐diabetes patients (19.8% vs 14.8%, P < 0.001). PE patients with diabetes had a higher prevalence of cardiovascular risk factors, comorbidities, right ventricular dysfunction (31.8% vs 27.7%, P < 0.001), prolonged in‐hospital stay (11.0 vs 9.0 days, P < 0.001) and higher rates of adverse in‐hospital events. Remarkably, diabetes was independently associated with increased in‐hospital mortality (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.20–1.23, P < 0.001) when adjusted for age, sex and comorbidities. Within the observation period of 2005–2018, a relevant decrease of in‐hospital mortality in PE patients with diabetes was observed (25.5% to 16.8%). Systemic thrombolysis was more often administered to diabetes patients (OR 1.18, 95% CI 1.01–3.49, P < 0.001), and diabetes was associated with intracerebral (OR 1.19, 95% CI 1.12–1.26, P < 0.001), as well as gastrointestinal bleeding (OR 1.11, 95% CI 1.07–1.15, P < 0.001). Type 1 diabetes mellitus was shown to be a strong risk factor in PE patients for shock, right ventricular dysfunction, cardiopulmonary resuscitation and in‐hospital death (OR 1.75, 95% CI 1.61–1.90, P < 0.001). Conclusions Despite the progress in diabetes treatments, diabetes is still associated with an unfavorable clinical patient profile and higher risk for adverse events, including substantially increased in‐hospital mortality in acute PE.

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Section: Discussionmentioning

confidence: 99%

Diabetes mellitus and its impact on mortality rate and outcome in pulmonary embolism

Schmitt

Hobohm

Sivanathan

et al. 2021

J of Diabetes Invest

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show abstract

“…[20,23,[25][26][27]37,41,44] Twenty articles with a total of 21 cohort studies reported the prognosis of VTE patients with or without DM, with a total of 1404,195 participants. Nine of the studies were followed up for ≥6 months (which we defined as long-term follow-up studies), [45][46][47][48][49][50][51][52][53] 5 were followed up for 30 days, [54][55][56][57][58] and 7 reported the risk of in-hospital mortality. [59][60][61][62][63][64] Fourteen studies were adjusted by sex, age, and other associated disease risks.…”

Section: Basic Characteristics Of Included Studiesmentioning

confidence: 99%

“…[59][60][61][62][63][64] Fourteen studies were adjusted by sex, age, and other associated disease risks. [43,[46][47][48][49][50][51][52][53]59,60] The included studies' essential characteristics are shown in Tables 1 and 2.…”

Section: Basic Characteristics Of Included Studiesmentioning

confidence: 99%

Association between diabetes and venous thromboembolism: A systematic review and meta-analysis

Ding,

Guo,

et al. 2023

Medicine

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Background: Diabetes mellitus (DM) plays a vital role in the development of cardiovascular disease. However, its association with venous thromboembolism (VTE) remains unclear, for the published study results are conflicting. We performed a meta-analysis of published cohort studies and case–control studies to assess the role of DM in the formation and prognosis of VTE. Methods: PubMed and EMBASE databases were searched for articles from the database’s establishment until September 15, 2022. Of the 15,754 publications retrieved, 50 studies were identified that met the selection criteria. The New castle-Ottawa Scale was used to evaluate the quality of the literature. Pooled odds ratios (ORs) and 95% confidence intervals were calculated using fixed- or random-effect models. Results: We combined OR using a random-effects or fixed-effects model: patients with DM had an increased risk of VTE (OR 1.27, 95% confidence interval [CI]: 1.15–1.41), which still showed a partial association in studies adjusted by confounding factors (OR 1.20, 95% CI: 1.07–1.35). DM was not significantly associated with VTE when analyzed in studies adjusted by body mass index (OR 1.04, 95% CI: 0.94–1.15). VTE patients with DM had a higher risk of short-term and long-term mortality than those without DM (OR 1.58 [95% CI: 1.26–1.99] for long-term mortality and OR 1.20 [95% CI: 1.19–1.21] for short-term mortality). Conclusion: There was no significant association between DM and VTE risk, and body mass index may be a significant confounding factor between DM and VTE risk. However, DM can still lead to an increased risk of long-term and short-term mortality in patients with VTE.

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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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The Influence of Gender in The Prognostic Impact of Diabetes mellitus in acute Pulmonary Embolism

Cited by 3 publications

References 24 publications

Diabetes mellitus and its impact on mortality rate and outcome in pulmonary embolism

Diabetes mellitus and its impact on mortality rate and outcome in pulmonary embolism

Association between diabetes and venous thromboembolism: A systematic review and meta-analysis

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

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