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在需要开放性手术干预的甲状腺病患者中存在性别差异
Megan E Lombardi1, Jonathan R Smith2, Colby S Ruiz3
1Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, NC.
Journal of vascular surgery
|July 21, 2023
概括
一年后,女性在公开的甲状腺干预后的死亡率较高,而男性患功能衰退的风险增加. 肢体救援和其他并发症在两性之间是相似的.
科学领域:
- 血管外科 血管外科
- 手术结果研究研究.
- 基于性别的健康差异
背景情况:
- 周围动脉疾病对男性和女性的影响不同.
- 之前的研究表明,在几个血管干预中,性别之间手术结果各不相同.
- 基于性别的结果差异在关闭性疾病的开放性手术治疗中需要客观量化.
研究的目的:
- 为了客观量化基于性别的差异的结果,为患者接受开放性手术干预的aortoiliac封闭性疾病.
- 为了比较30天和1年的死亡率,肢体救援和男性和女性患者之间的并发症率.
主要方法:
- 从血管质量倡议数据库 (2012-2019) 中对甲状腺封闭性疾病患者的分析.
- 包括接受大动脉双绕道或大动脉血栓内膜切除术的患者,并至少进行1年的随访.
- 使用二项式回归计算死亡率和肢体救援风险差异的计算,用反向概率权重和多变量逻辑回归来控制混因素.
主要成果:
- 在16218名患者中,40.3%是女性;人口和病史在两性之间是相似的.
- 没有观察到30天死亡率的显著差异.
- 女性的1年死亡率更高 (RD 0.014),而男性的术后功能下降的发病率更高 (RD -0.02).
结论:
- 虽然30天的死亡率相似,但女性在公开的胸膜干预后面临着显著更高的1年死亡率.
- 与女性相比,男性患者在术后表现出功能下降的统计显著增加.
- 长时间住院,重手术,伤口并发症和肢体保存1年的比例在两性之间是可比的,这需要进一步调查观察到基于性别的结果差异的潜在因素.
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