{
  "abstract": "Background. In hemodynamically stable acute pulmonary embolism (PE), right ventricular dysfunction (RVD) is a key determinant of early risk. Hypoxemia at presentation is common and may reflect ventilation–perfusion mismatch or the worsening of pre-existing respiratory failure due to non-PE causes. Whether hypoxemia adds prognostic information beyond RVD remains uncertain. Purpose. The aim of this study was to evaluate the independent and combined associations of RVD and hypoxemia with short-term mortality in acute PE. Methods. We conducted an individual patient data meta-analysis of observational studies including adults with objectively confirmed acute PE (PROSPERO CRD4202238420). Respiratory insufficiency was defined as oxygen saturation <90% on room air at presentation. The primary outcome was short-term all-cause mortality (in-hospital or ≤30 days); the secondary outcome was PE-related mortality. Mixed-effects logistic regression models with random intercept for study were used. Patients were classified into three groups: neither condition, either RVD or hypoxemia alone, and both conditions. An interaction term assessed effect modification. Results. The analysis included 2,218 patients from six studies. Overall, 52.6% had neither condition, 36.4% had one, and 11.0% had both. Short-term all-cause mortality increased progressively across groups (4.5%, 7.8%, and 11.1%). Compared with patients without either condition, the odds of death were higher in those with one condition (OR 1.88, 95% CI 1.29–2.76) and highest in those with both (OR 2.68, 95% CI 1.64–4.37). In the subset with data on PE-related mortality (n=1,844), mortality rose from 1.9% (reference) to 4.0% (OR 2.39, 95% CI 1.30–4.39) and to 7.2% (OR 4.36, 95% CI 2.17–8.75) in the three groups, respectively. Among hemodynamically stable patients (n=2,152), the associations remained consistent (neither condition=reference, one condition: OR 1.86, 95% CI 1.25–2.77; both: OR 2.25, 95% CI 1.31–3.88). Similar results were observed for PE-related mortality. No significant interaction was detected (p=0.43 for all-cause; p=0.67 for PE-related mortality), indicating additive rather than synergistic effects. Conclusions. In hemodynamically stable acute PE, hypoxemia identifies a clinically meaningful subgroup at increased short-term risk, particularly when combined with RVD. Mortality exceeded 11% in patients presenting with both conditions despite initial stability. Integrating oxygenation status with cardiac imaging markers may refine early risk stratification and support closer monitoring or timely therapeutic escalation.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 1,
  "authors": [
    {
      "name": "Ludovica Anna Cimini"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2g2fsj19k9jqk.bib",
  "cited_by": 0,
  "doi": null,
  "fulltext_url": "https://www.btvb.org/btvb/article/view/755",
  "id": "2g2fsj19k9jqk",
  "issns": [
    "2785-5309"
  ],
  "landing_url": "https://www.btvb.org/btvb/article/view/755",
  "language": "en",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC666-701"
    ]
  ],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-26",
  "publisher": "PAGEPress Publications",
  "ris": "https://research.draconitic.com/paper/2g2fsj19k9jqk.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:47:32Z",
      "native_id": "ab946127f4f64e42ad13631a40a9c8c8",
      "source": "doaj",
      "url": "https://www.btvb.org/btvb/article/view/755"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "lcc:RC666-701",
      "subfield": "cardiovascular"
    }
  ],
  "title": "CO053 | PROGNOSTIC IMPACT OF RIGHT VENTRICULAR DYSFUNCTION AND HYPOXEMIA IN HEMODYNAMICALLY STABLE ACUTE PULMONARY EMBOLISM: AN INDIVIDUAL PATIENT DATA META-ANALYSIS",
  "title_text": "CO053 | PROGNOSTIC IMPACT OF RIGHT VENTRICULAR DYSFUNCTION AND HYPOXEMIA IN HEMODYNAMICALLY STABLE ACUTE PULMONARY EMBOLISM: AN INDIVIDUAL PATIENT DATA META-ANALYSIS",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:47:32Z",
  "url": "https://research.draconitic.com/paper/2g2fsj19k9jqk",
  "venue": "Bleeding, Thrombosis and Vascular Biology",
  "versions": []
}