The impact of age and sex on clinical symptoms in low and intermediate-low risk pulmonary embolism

Aims: The diagnostic process of pulmonary thromboembolism (PTE) can be complex due to its wide spectrum of clinical presentations. The type and frequency of symptoms vary not only with the embolism risk category but also in relation to individual demographic factors such as age and sex. This study aims to evaluate the influence of demographic variables on clinical presentation by investigating the distribution of symptoms according to age and sex in patients with acute PTE classified as low or intermediate-low risk. Methods: This retrospective, cross-sectional study was conducted at the Emergency Department of Dışkapı Yıldırım Beyazıt Training and Research Hospital between February 1, 2020, and February 1, 2021. A total of 329 patients aged 18 years and older who were classified as low or intermediate-low risk according to the 2019 European Society of Cardiology guidelines were included in the study. The patients’ demographic characteristics and clinical symptoms were retrospectively analyzed. Symptom distributions were compared across different age and sex groups. Results: The most frequently reported symptoms among patients were dyspnea (79.3%) and chest pain (53.7%). Leg pain and/ or swelling were significantly more common in younger male patients (26%, p=0.001), while presyncope was more frequently observed in older female patients (27.3%, p=0.001). Hemoptysis was found to be significantly less common in older female patients compared to other groups (8.2%, p=0.012). Conclusion: The symptom profile in PTE varies significantly based on patients’ demographic characteristics. Our study suggests that recognizing these differences during the diagnostic process may help facilitate clinical management by preventing diagnostic delays, particularly in patient groups presenting with atypical symptoms.