{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T11:06:42Z","timestamp":1784027202592,"version":"3.55.0"},"reference-count":20,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiologia"],"abstract":"<jats:p>Background: Pulmonary embolism (PE) is a leading cause of morbidity and mortality worldwide, ranking third among cardiovascular-related deaths after myocardial infarction and stroke. Despite extensive research, data on PE incidence and characteristics within the Israeli population remain limited. This study aimed to investigate the demographic, clinical, and prognostic factors associated with provoked (PPE) and unprovoked PE (UPE) cases in Israel. Methods: We conducted a retrospective observational study analyzing medical records of patients diagnosed with PE at Ziv Medical Center, Safed, Israel, from 2017 to 2022. Patients were classified into PPE or UPE groups based on identifiable risk factors. Demographic data, clinical characteristics, and mortality outcomes were compared using descriptive and inferential statistical methods, including the Mann\u2013Whitney U test, chi-square test, logistic regression, Kaplan\u2013Meier survival analysis, and Cox proportional hazards modeling. Results: A total of 348 patients (mean age: 68.6 \u00b1 17.6 years; 54.3% female) were included, with 189 (54.3%) classified as PPE and 159 (45.7%) as UPE. Female patients were significantly older than males (p &lt; 0.001), and Jewish patients were slightly older than Arab patients (p = 0.060). The average hospital stay was 10.7 \u00b1 16.2 days. Although no group differences emerged in unadjusted analyses, male sex was associated with longer hospitalization and UPE with shorter hospitalization than PPE in the adjusted model. Ethnicity emerged as a significant predictor of PE type, with Jewish patients less likely to have UPE (OR = 0.457, 95% CI 0.256\u20130.817, p = 0.008). Among PPE cases, 67.2% were of Jewish origin and 32.8% were Arab, compared to 56.0% and 44.0%, respectively, in the UPE group. In-hospital mortality was 16.1% (n = 56). Age was a significant predictor of mortality (HR = 1.03, 95% CI 1.00\u20131.06, p = 0.020), while ethnicity, gender, and PE type showed no significant associations in multivariable models. Conclusions: Our findings highlight key demographic and clinical factors influencing PE outcomes in Israel. The significant association between ethnicity and PE type warrants further investigation to refine diagnostic and therapeutic strategies for high-risk populations.<\/jats:p>","DOI":"10.3390\/epidemiologia7040101","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T10:12:53Z","timestamp":1784023973000},"page":"101","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiology, Risk Factors, and Mortality in Unprovoked and Provoked Pulmonary Embolism\u2014A Single-Center Retrospective Study in the Israeli Population: Gender and Ethnic Differences"],"prefix":"10.3390","volume":"7","author":[{"given":"Raymond","family":"Farah","sequence":"first","affiliation":[{"name":"Internal Medicine B Department, Ziv Medical Center, Safed 13100, Israel"},{"name":"Azrieli Faculty of Medicine, Bar Ilan University, Galilee, Safed 13100, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8409-868X","authenticated-orcid":false,"given":"Nicola Luigi","family":"Bragazzi","sequence":"additional","affiliation":[{"name":"Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON M3J 1P3, Canada"},{"name":"Department of Health Sciences (DISSAL), Postgraduate School of Public Health, University of Genoa, 16132 Genoa, Italy"},{"name":"United Nations Educational, Scientific and Cultural Organization (UNESCO) Chair, Health Anthropology Biosphere and Healing Systems, University of Genoa, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2214-4667","authenticated-orcid":false,"given":"Halil \u0130brahim","family":"Ceylan","sequence":"additional","affiliation":[{"name":"Physical Education and Sports Teaching Department, Faculty of Sports Sciences, Atat\u00fcrk University, 25240 Erzurum, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0973-5455","authenticated-orcid":false,"given":"\u0141ukasz","family":"Szarpak","sequence":"additional","affiliation":[{"name":"Department of Clinical Research and Development, LUX MED Group, 02-676 Warsaw, Poland"},{"name":"Institute of Medical Science, Collegium Medicum, The John Paul II Catholic University of Lublin, 20-950 Lublin, Poland"},{"name":"The World Academic Council of Emergency Medicine (WACEM), Sarasota, FL 34236, USA"},{"name":"Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7130-1367","authenticated-orcid":false,"given":"Agnese Maria","family":"Fioretti","sequence":"additional","affiliation":[{"name":"Cardio-Oncology Unit, IRCCS Istituto Tumori \u201cGiovanni Paolo II\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wisam","family":"Mahajna","sequence":"additional","affiliation":[{"name":"Internal Medicine B Department, Ziv Medical Center, Safed 13100, Israel"},{"name":"Azrieli Faculty of Medicine, Bar Ilan University, Galilee, Safed 13100, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noor","family":"Ashqar","sequence":"additional","affiliation":[{"name":"Internal Medicine B Department, Ziv Medical Center, Safed 13100, Israel"},{"name":"Azrieli Faculty of Medicine, Bar Ilan University, Galilee, Safed 13100, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rola","family":"Khamisy-Farah","sequence":"additional","affiliation":[{"name":"Azrieli Faculty of Medicine, Bar Ilan University, Galilee, Safed 13100, Israel"},{"name":"Clalit Health Service, Akko 24124, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"ref_1","unstructured":"Vyas, V., Sankari, A., and Goyal, A. 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