Abstract 4369789: Sex differences in short-term PE outcomes in older adults: The SERIOUS-PE Multinational Study
Bibliographic record
Abstract
Background: Several studies have assessed sex differences in outcomes of patients with pulmonary embolism (PE). However, they have been limited by small sample sizes, lack of a prespecified protocol, or other methodological problems. Aims: The SERIOUS-PE study was designed for rigorous prespecified analyses in patients aged ≥65 years, a group most likely to suffer from PE and its adverse outcomes. Methods: We used data from the RIETE registry (predominantly representing Europe) and a validated algorithm using ICD-10 codes to identify US Medicare Fee-For-Service beneficiaries with PE. To focus on clinically-relevant differences in clinical characteristics, standardized differences (SRD)>10% were considered. Thirty-day outcomes were assessed in unadjusted and adjusted models. Results: The outcomes analysis included 33,462 patients from RIETE (age 77.6 years, 59.5% female) and 666,128 from Medicare (age 73.5 years, 53.9% female). Females were older than males (SRD: 34% [RIETE] and 30% [Medicare]), and more frequently had varicose veins, immobility, depression, or hormonal therapy (SRD>10%). Males more frequently had atherosclerotic diseases and cancer (SRD>10%). Thrombus burden, PE risk stratification, anticoagulant therapy, and advanced therapies did not have clinically-relevant differences between groups (SRD<5%). 30-day mortality occurred in 6.4% of females and 6.8% of males in RIETE (OR 0.91, 95% CI 0.83-1.00) and 15.2% of females and 16.5% of males in Medicare (OR 0.91, 95% CI 0.90-0.92). After adjusting for age and other covariates, females had a higher risk of mortality than males in RIETE (aOR 1.24, 95% CI 1.11-1.39) and in Medicare (aOR 1.10, 95% CI 1.08-1.13). 30-day readmission occurred in 14.7% of females and 15.1% of males in Medicare (OR 0.97, 95% CI 0.96-0.99, and aOR 1.00, 95% CI 0.98-1.01). Conclusions: This is the most comprehensive assessment of sex differences in presentation, treatment strategies, and outcomes of older adults with PE. Sex differences in crude vs adjusted mortality warrant additional investigation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".