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在中期和高风险肺栓塞的先进治疗干预中性别差异
Christiana K Prucnal1, Christopher Kabrhel2, Nora K Horick3
1Department of Emergency Medicine, Harvard Medical School, Boston, MA.
Clinical therapeutics
|December 4, 2024
概括
性别没有显著影响急性肺栓塞 (PE) 的高级干预率. 临床因素,如通风和代码状态,比患者的性别更能预测治疗.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 先进的干预越来越多地用于中等和高风险的急性肺栓塞 (PE).
- 现有的研究强调了各种疾病中的基于性别的差异,但它们在PE治疗中的存在仍然不清楚.
研究的目的:
- 调查在急性肺栓塞 (PE) 中使用先进干预措施的潜在基于性别的差异.
- 为了确定与接受先进疗法在PE患者相关的因素.
主要方法:
- 一项前性队列研究的二次分析,涉及902名已成年患者,已确认中期和高风险急性PE.
- 从2012-2021年收集的数据在一家三级医院,专注于PE响应小组的激活.
- 统计分析包括奇平方测试,t测试和后勤回归,以评估先进干预接收的预测因素.
主要成果:
- 在接受急性PE先进干预的情况中,没有观察到基于性别的显著差异 (18.7%的女性与23.5%的男性,P = 0.129).
- 女性呈现出较高的右心应变率和较高的NT-proBNP,但临床PE严重程度没有性别差异.
- 高风险PE,辅助呼吸和完整代码状态是接受先进疗法的重要预测因素.
结论:
- 虽然基线临床特征显示急性PE呈现的性别差异,但性别本身不是接受高级干预措施的预测因素.
- 临床因素,而不是性别,似乎是急性PE管理中先进治疗决策的主要驱动因素.
- 这项研究对PE干预中性别差异的有限文献做出了贡献.
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