破裂腹腔大动脉动脉瘤的性别差异管理和结果:最新情况
Shirin Saeed1, Mark Robitaille1, Usman Ahmed1
1Department of Anesthesia, Critical Care & Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA.
Journal of cardiothoracic and vascular anesthesia
|January 10, 2025
概括
性差异对破裂腹腔大动脉瘤 (AAA) 修复后的结果产生影响. 女性面临更高的死亡率和延迟治疗,而男性患上更多的并发病,需要针对性别的护理策略.
科学领域:
- 血管外科 血管外科
- 心血管研究研究心血管研究
- 健康差异 在健康上的差异
背景情况:
- 破裂腹腔大动脉动脉瘤 (AAA) 修复结果在性别之间可能有很大的差异.
- 了解这些基于性别的差异对于优化患者护理和提高生存率至关重要.
研究的目的:
- 为了评估基于性别的死亡率,发病率和经过AAA修复破裂后的术后并发症的差异.
- 在破裂的AAA患者中,确定与性别相关的特定风险因素和结果.
主要方法:
- 使用来自血管质量倡议国家数据库 (2003-2022) 的多机构数据的回顾性队列研究.
- 分析包括了7,548名患者 (5,829名男性,1,719名女性),他们因破裂的AAA而接受开放或内血管修复.
主要成果:
- 随着时间的推移,两性死亡率显著下降.
- 男性的冠状动脉疾病和先前干预率更高,而女性呈现较老,有更多的高血压,并且从症状发作到修复的延迟时间更长.
- 女性的住院死亡率更高 (OR 1.27),而男性的心血管和肺部并发症更严重.
结论:
- 在破裂的AAA修复结果中存在显著的基于性别的差异.
- 男性出现的并发症负担较高,而女性年龄较大,经历治疗延迟.
- 针对性别的指导方针和干预措施对于改善所有接受破裂AAA修复的患者的治疗结果至关重要.
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