Sex-based differences in access to reperfusion therapies for pulmonary embolism in Spain during the 2016–2022 period

Background/objectives

Evidence on sex-based differences in access to reperfusion therapies for PE remains conflicting. This study evaluated such differences in Spain during the 2016–2022 period.

Methods

We identified all patients with PE in the Registro de Actividad Especializada-Conjunto Mínimo Básico de Datos from 2016 to 2022. The proportions of men and women undergoing systemic fibrinolysis, catheter-directed thrombolysis, embolectomy, or extracorporeal membrane oxygenation were compared. Multivariable adjustment was performed using logistic regression.

Results

We identified 113,787 women and 115,941 men. Women were significantly older (73 vs 68 years) and were more likely to have heart failure (15.1 % vs 11.8 %) and dementia (13.3 % vs 7.4 %), whereas men were more likely to have coronary artery disease (4.5 % vs 2.0 %), chronic obstructive pulmonary disease (20.8 % vs 12.0 %), and cancer (23.7 % vs 18.6 %). However, the overall comorbidity burden was similar between groups, with a median Charlson's Index of 1 for both. Crude analysis showed similar proportions of reperfusion therapy for men and women: 5.36 % (95 % CI: 5.22 %–5.48 %) vs 5.23 % (95 % CI: 5.10 %–5.36 %) respectively. Comorbidity emerged as the variable with the greatest impact on adjustment in the multivariable regression. After adjustment, women appeared to have a lower probability of receiving these treatments (POR 0.98; 95 % CI: 0.94–1.01).

Conclusions

After adjusting for confounders, women diagnosed with PE may have been less likely to undergo reperfusion therapies in Spain during the period from 2016 to 2022.