在4680个腰椎融合结果中,因性别差异而导致的差异
Ritesh Karsalia1, Ryan S Gallagher1, Austin J Borja1
1Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
World neurosurgery
|December 22, 2024
概括
经历腰部融合手术的女性患者在医院住院时间更长,更有可能被送往家庭以外的机构,即使控制了其他因素. 重新入院和重复手术没有显示出基于性别的显著差异.
科学领域:
- 脊柱手术的结果 脊柱手术的结果
- 患者报告的医疗保健中的性别差异
背景情况:
- 有限的研究存在于控制变量腰部融合结果的基于性别的差异.
- 缩精确匹配 (CEM) 是一种新的方法,用于控制手术结果研究中的混因素.
研究的目的:
- 为了确定患者报告的性别对脊柱融合结果的影响.
- 为了研究腰部融合手术后短期结果的基于性别的差异.
主要方法:
- 追溯分析4680名成年人的单层,仅后部的腰部合并.
- 粗制精确匹配 (CEM) 用于根据人口和医疗因素创建1:1匹配的男女对.
- 主要结局:30/90天再入院,急救访问,重新手术,死亡率. 二次结果:出院安排,停留时间.
主要成果:
- 女性在非家庭出院的几率明显更高 (OR 1.70,P < 0.001).
- 女性住院时间较长 (平均95.7小时 vs. 87小时,P<0.001).
- 在匹配的男性和女性队伍之间的再接收或重新手术中没有观察到显著差异.
结论:
- 女性患者面临更长的住院时间,并且在腰部融合后非家庭出院的可能性增加.
- 即使使用CEM控制关键患者级变量后,这些差异仍然存在.
- 进一步的研究可能会探索这些基于性别的结果差异的潜在原因.
相关概念视频
X-linked Traits
In most mammalian species, females have two X sex chromosomes and males have an X and Y. As a result, mutations on the X chromosome in females may be masked by the presence of a normal allele on the second X. In contrast, a mutation on the X chromosome in males more often causes observable biological defects, as there is no normal X to compensate. Trait variations arising from mutations on the X chromosome are called “X-linked”.
Sex-linked Disorders
Like autosomes, sex chromosomes contain a variety of genes necessary for normal body function. When a mutation in one of these genes results in biological deficits, the disorder is considered sex-linked.
Nondisjunction
During meiosis, chromosomes occasionally separate improperly. This occurs due to failure of homologous chromosome separation during meiosis I or failed sister chromatid separation during meiosis II. In some species, notably plants, nondisjunction can result in an organism with an entire additional set of chromosomes, which is called polyploidy. In humans, nondisjunction can occur during male or female gametogenesis and the resulting gametes possess one too many or one too few chromosomes.
X and Y Chromosomes
Among mammals, the gender of an organism is determined by the sex chromosomes. Humans have two sex chromosomes, X and Y. Every human diploid cell has 22 pairs of autosomes and one pair of sex chromosomes. A human female has two X chromosomes, while a male has one X chromosome and one Y chromosome.
The germline cells such as egg and sperm cells carry only half the number of chromosomes, i.e., 22 autosomes and one sex chromosome. All eggs have an X chromosome, while sperm cells can carry an X or...
The germline cells such as egg and sperm cells carry only half the number of chromosomes, i.e., 22 autosomes and one sex chromosome. All eggs have an X chromosome, while sperm cells can carry an X or...
The Ratio of X Chromosome to Autosomes
In most organisms, sex is determined by the ratio of X and Y chromosomes. However, in some organisms, such as Drosophila and C.elegans, sex is determined by the ratio of the number of X chromosomes to the number of sets of autosomes. The Y chromosome in Drosophila is active but does not determine sex. It contains genes responsible for the production of sperms in adult flies.
Normal male Drosophila has a ratio of one X chromosome to two sets of autosomes. In contrast, normal female Drosophila...
Normal male Drosophila has a ratio of one X chromosome to two sets of autosomes. In contrast, normal female Drosophila...


