急性冠状动脉综合征中的性别差异:跨护理连续性的范围审查
Anna Marzà-Florensa1, Pauline Kiss1, Dina Mohamed Youssef1
1Global Public Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
在急性冠状动脉综合征 (ACS) 护理中,性别差异很普遍,特别是在医院前和诊断阶段,结果往往有利于男性. 需要在全球范围内进行进一步的研究,以解决ACS管理中的这些关键缺口.
科学领域:
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
- 医学中的性别和性别.
背景情况:
- 对急性冠状动脉综合征 (ACS) 的最佳诊断和管理对于改善患者的治疗结果至关重要.
- 现有的文献表明,在ACS护理中存在性别差异,但全面的全球证据仍然有限.
研究的目的:
- 系统地审查和总结全球证据在整个ACS连续性的提供护理的性别差异.
- 确定ACS护理中性别差异最明显的特定领域.
主要方法:
- 在主要数据库 (PubMed,EMBASE,世卫组织全球医学指数) 进行了系统的文献搜索.
- 包括的研究发表于2013年1月至2023年8月期间,以英语,西班牙语,荷兰语或法语,重点关注医院前护理,诊断,治疗,住院事件和出院.
- 分析包括了446篇文章,报告了1483个结果.
主要成果:
- 大多数研究 (65%) 来自高收入地区.
- 在ACS护理结果中的性别差异报告了45%的结果有利于男性,5%有利于女性,50%显示没有差异或混合结果.
- 医院前护理 (58%的结果有利于男性) 和诊断 (70%的结果有利于男性) 呈现出最显著的性别差异.
结论:
- 在ACS管理中的性别差异得到了广泛的证据,主要趋势不利于女性.
- 这些差异在护理的早期阶段尤其明显,包括医院前和诊断阶段.
- 目前的证据主要来自高收入国家,强调需要更广泛的全球研究.
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