Sex‐related difference in the prognostic value of syncope for 30‐day mortality among hospitalized pulmonary embolism patients

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.