高血压急诊诊所的性别差异:一项全国性回顾性队列研究
Garry Francis-Morel1, Nehemias A Guevara1, Mushrin Malik1
1Internal Medicine, St. Barnabas Hospital Health System, Bronx, USA.
Cureus
|July 14, 2023
概括
患有高血压紧急情况的男性患者面临更高的死亡风险. 这项研究发现,男性性别是死亡的独立预测因素,突出了管理这种关键疾病的潜在性别差异.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 全球近20%的成年人患有高血压,高血压紧急情况带来严重的,危及生命的风险.
- 尽管治疗方面取得了进展,但在管理高血压紧急情况及其结果方面仍然存在严重的性别差异.
- 了解这些差异对于改善患者护理和降低与严重高血压相关的死亡率至关重要.
研究的目的:
- 调查发生高血压紧急情况的患者的潜在性别差异.
- 在这个患者群体中确定死亡率,住院时间和住院费用的预测因素.
- 分析高血压紧急情况中性别和全因住院患者死亡率之间的关联.
主要方法:
- 使用来自医疗保健成本和利用计划 (HCUP) 的全国住院患者样本 (NIS) 的回顾性队列研究.
- 对229,025名成年患者的分析,按性别分层,主要结局是全因住院患者死亡率.
- 采用多变量逻辑和线性回归模型来确定结果的独立预测因子,控制混因子.
主要成果:
- 男性性别被确定为死亡率的独立预测因素 (aOR1.39,p=0.036),表明与女性相比,男性的风险高39%.
- 增加的年龄 (aOR 1.02) 和更高的查尔森并发症指数 (aOR 1.20) 也是死亡率的重要预测因素.
- 在住院时间 (p=0.496) 或总住院费用 (p=0.192) 方面,性别之间没有发现显著差异.
结论:
- 经历高血压紧急情况的男性患者与女性患者相比,在医院内死亡的风险明显更高.
- 年龄和整体并发症负担是影响高血压紧急情况死亡率的关键因素,不论性别.
- 这些发现强调了需要在高血压紧急情况的管理和治疗方案中解决性别特异因素的必要性.
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