Acute Pulmonary Embolism in Women: Focus on Estrogen Therapy as a Predisposing Factor

Abstract

Objectives:Acute pulmonary embolism (APE) is a potentially fatal disorder. The literature shows that estrogen therapy is correlated with an increase in mortality and morbidity. Accordingly, the purpose of the present study was to investigate the prevalence and prognostic significance of recent history of estrogen therapy in women with APE. Methods: This study was conducted on female patients admitted to our hospital between January 2008 and January 2016. A total of 276 patients (mean age = 62.66 ± 08 y) with confirmed APE were divided into groups with and without recent estrogen therapy. The relationships between estrogen and clinical findings, risk factors, imaging findings, and in-hospital mortality were analyzed. Results: Among the 276 women with APE at presentation, 37 (13.4%) patients had a recent history of estrogen therapy. The estrogen group had a lower frequency of hypertension (21.6% vs49.8%; P< .001), immobilization of at least 3 days (16.2% vs 33.5%; P = .035), and pleural effusion (0% vs16.7%; P = .007) than the group without recent estrogen use. Among the 276 patients, the rate of 1 year’s mortality was 15.8% for the group without recent estrogen therapy. No death occurred in the estrogen group. Conclusion: older age, tachycardia, tachypnea, malignancy, and lack of obesity were the predictors of 1 year’s mortality. Among the patients with APE in our study, 13.4% had a history of recent estrogen therapy. No death occurred during the 1-year follow-up of these patients.

Keywords

• Pulmonary embolism
• Estrogen
• Mortality
• Thromboembolism
• Deep vein thrombosis