冠動脈外科手術患者の臨床的特徴の変化. 男性と女性の違い
W S Weintraub1, N K Wenger, E L Jones
1Division of Cardiology, Emory University Hospital, Atlanta, GA 30322.
Circulation
|November 1, 1993
まとめ
冠動脈バイパス移植手術 (CABG) の結果は,男女ともに死亡率が増加しており,女性は年齢,併発症,および疾患の重症度により不釣り合いの高いリスクを経験しています.
科学分野:
- 心血管外科手術についてです.
- 医学的な成果 研究研究
- 健康の格差について
背景:
- 男性と女性の間で冠動脈バイパス移植手術 (CABG) の比較効果に関して不確実性があります.
- 有害なアウトカムの危険因子の増加傾向は,CABGの有効性における性差の再評価を必要とします.
- この研究は,患者の特徴の進化とその両性におけるCABG結果への影響を分析することを目的としています.
研究 の 目的:
- CABGを受ける患者の臨床プロフィールの時間的な変化を調査する.
- これらの変化が男性と女性のCABG結果にどのように影響するかを判断する.
- CABGの結果に影響を与える性特有のリスク要因を特定する.
主な方法:
- エモリー大学病院の臨床データベースの分析で,1974年から1991年の間にCABGを受けた患者13,368人を含む.
- 患者は4つの時期 (1974年 - 1979年, 1980年 - 1983年, 1984年 - 1987年, 1988年 - 1991年) に分かれました.
- 将来のデータ収集とコンピュータ化されたデータベースの入力,死亡率相関の多変量分析.
主要な成果:
- CABGを受けた女性は高齢で,男性に比べて糖尿病の罹患率が高かった.
- 病院での死亡率は,男性 (1.6%) よりも女性 (3.8%) で著しく高かった.
- 多変量分析により,女性の性別,高齢化,糖尿病,より重度の冠動脈疾患が死亡の相関因子として特定され,死亡率は時間とともに女性においてより急激に増加した.
結論:
- CABG患者の人口は高齢化しており,病院での死亡リスク要因の有病率が高くなっています.
- 女性ではCABG後の死亡率が高く,これは臨床的変数で部分的に説明できる.
- 女性における死亡リスクの上昇は,一貫した年齢差,新たな手術や糖尿病の発生率の上昇,そして近年における重度の冠動脈疾患のより高い罹患率と関連している.
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