Acute Pulmonary Embolism in Oman: A Situational Analysis.

Abstract

Objectives: Pulmonary embolism (PE) is increasingly prevalent in Oman. The aim of this situational analysis of PE among Omani patients was to study its predisposing factors, diagnostic issues, and optimal management.

Methods: In this retrospective cross-sectional situational analysis, the subjects were Omani patients who were diagnosed with acute PE using computed tomography pulmonary angiogram from 2010-2021. The required data was collected from the hospital database and statistically analyzed.

Results: The subjects were 438 patients diagnosed with PE, with a mean age of 53.3±18.5 years and mean body mass index of 29.7±7.3 kg/m². Males were in a slight majority (223; 50.9%) and were older (55.0±18.5 years) than females (51.5±18.3 years). Two-thirds of the PE patients had hypertension and one-third had diabetes mellitus. Most patients presented with dyspnea and chest pain. Syncope was more common in females compared to males who mostly presented with hemoptysis. Nearly half of the patients had abnormal echocardiogram, and males had lower mean ejection fraction compared to females. Different modalities of management were used to treat patients' PE. Heparin was the most used anticoagulant followed by warfarin and direct oral anticoagulants. Out of the 122 PE patients who died during the study period, PE was the direct cause of death of 68 patients. The mortality was higher in males than in females.

Conclusions: The incidence of acute PE was similar among both male and female Omani patients. However, there were sex differences in risk factors, symptoms, investigations, and management of PE. Females presented with more severe PE, but mortality was higher in males.