In a patient with pulmonary embolism, which factors increase in-hospital mortality risk?

• A. Young age and hypotension
• B. Advanced age and obstructive shock
• C. Moderate obesity
• D. Female sex with normal vitals

Answer: (B)

In pulmonary embolism, mortality risk rises when the heart is suddenly unable to cope with the obstruction (hemodynamic instability) and when the patient has limited physiologic reserve due to age. Advanced age means less cardiopulmonary reserve and more comorbidities, while obstructive shock from a massive PE signals acute right ventricular failure and systemic hypoperfusion. This combination—age-related vulnerability plus a life-threatening hemodynamic collapse—is the strongest predictor of in-hospital death.

So the scenario describing advanced age with obstructive shock best fits factors that increase mortality risk. By contrast, young age with hypotension suggests shock but age would usually confer some protective reserve; moderate obesity alone and female sex with normal vitals don’t imply the same immediate high risk.