Untersuchung geschlechtsspezifischer Unterschiede für den Verlauf einer akuten Lungenembolie
Sex related differences in acute pulmonary embolism
von Lisa Franziska Rappold
Datum der mündl. Prüfung:2018-02-27
Erschienen:2018-02-21
Betreuer:Prof. Dr. Claudia Dellas
Gutachter:Prof. Dr. Claudia Dellas
Gutachter:Dr. Uwe Raaz
Dateien
Name:Ediss- Lisa Rappold- Untersuchung geschlecht...pdf
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Zusammenfassung
Englisch
Gender variations in cardiovascular disease have been widely studied, but the findings to date in literature on gender differences in pulmonary embolisms are minimal. Data from the Pulmonary Embolism Registry of Göttingen (PERGO) were tested for sex-related variations. All patients, as well as a subgroup consisting of only hemodynamically stable patients, were analysed for statistically significant differences in both sexes using Fisher’s exact test and the Mann Whitney U test. A univariate logistic regression model was used to estimate risk factors for the defined endpoints (I. all-cause death within 30 days, II: Intubation, catecholamine therapy, resuscitation or death within 30 days). 569 patients were included in the study. It turned out that women (55.9%) suffered a pulmonary embolism more frequently than men (44.1%). The median age was higher for women (71) than it was for men (67). The clinical signs (heart rate, signs of right heart failure) suggested a more severe pulmonary embolism in women, and women were more likely to experience thrombolytic therapy and more frequent bleeding. However, there was no significant gender difference in 30-day mortality and long-term survival. In univariate regression, factors could be isolated in both groups that contributed significantly to the increase in risk of reaching the endpoints. Hypoxia in both groups was associated with a significant increase in risk for adverse outcomes in both men and women. Signs of right heart failure in the ECG and echocardiography significantly increased the risk for an adverse outcome in women. The results of this study show that only a few gender differences in pulmonary embolisms were found in the analysed populations. Consequences for daily clinical routines could arise with regard to the risk assessment, especially in women with increased heart rate and sings of right heart failure in the echocardiography, in the ECG and in the laboratory parameters.
Keywords: Pulmonary Embolism; sex differences; gender differences