儿科重症监护室的死亡率是否存在性别差异? :一个系统的审查
Ofran Almossawi1,2, Amanda Friend3, Luigi Palla4,5
1Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.
Frontiers in pediatrics
|October 25, 2023
概括
在儿科重症监护室 (PICU),女性的死亡率略高于男性,尽管整体入院率较低. 这项系统性审查分析了超过278,000名儿童,以了解PICU死亡率的性别差异.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 流行病学 流行病学
- 生物统计学 生物统计学
背景情况:
- 婴儿和童年死亡率在女性中通常低于男性.
- 然而,在儿童重症监护室 (PICU) 住院的儿童中,出现了反向趋势,尽管住院率较低,但女性的死亡率更高.
- 在PICU小组中女性死亡率过高的原因尚不清楚.
研究的目的:
- 进行一项系统的文献审查,以性别为基础的差异死亡率的儿童 (0至18岁以下) 进入PICU.
- 为了确定男性和女性之间是否存在PICU死亡率的显著差异.
- 量化任何观察到的基于性别的死亡率差异的幅度和方向.
主要方法:
- 在MEDLINE,Embase和Web of Science的系统文献搜索报告PICU死亡率按性别的研究.
- 纳入标准包括报告重症监护室儿童死亡率数据的研究,按性别分层.
- 使用修改后的ROBINS-E工具评估了研究可靠性;如果≥3项研究是可比的,则考虑进行聚合分析.
主要成果:
- 分析包括114项研究,涉及278274名儿童 (56%的男性,44%的女性).
- 女性死亡率为4.61% (5,614人死亡),男性死亡率为4.36% (6,828人死亡).
- 聚合分析表明,女性与男性死亡率的几率比率为1.06 (固定效应) 和1.10 (随机效应),这表明女性死亡率略高.
结论:
- 总的来说,男性在PICU的入院率较高,死亡率可能比女性更低.
- 这些发现表明,在接受PICU治疗的女性中,死亡风险微妙但在统计学上显著增加.
- 需要进一步的研究,以阐明导致儿童重症监护结果中这种观察到的性别差异的潜在机制.
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