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败血症的呈现,干预措施,以及在急诊室的男性和女性之间的结果差异
Joseph O'Brien1, Jon W Schrock2
1Cleveland Clinic Lerner College of Medicine, Department of Emergency Medicine, Cleveland, Ohio.
The western journal of emergency medicine
|August 12, 2025
概括
与男性相比,患有败血症的女性的死亡率比男性低10%. 尽管如此,女性接受的血管抑制剂和抗生素较少,突出显示了毒症治疗中的潜在性别差异.
科学领域:
- 关键护理医学 关键护理医学
- 流行病学 流行病学
- 健康中的性别差异
背景情况:
- 败血症是一种危及生命的紧急情况,死亡率高.
- 现有的关于败血症性结局的研究提出了相互矛盾的发现.
- 了解败血症呈现,治疗和结果的性别差异对于改善患者护理至关重要.
研究的目的:
- 为了调查毒症临床表现的基于性别的差异.
- 分析对男性和女性败血症患者进行的干预措施的变化.
- 为了比较进入急诊室的败血症患者性别之间的死亡率.
主要方法:
- 使用TriNetX研究网络 (119个国际医疗保健组织) 的回顾性队列研究.
- 根据国际疾病分类第10版 (ICD-10) 代码进行败血症鉴定.
- 1:1倾向性得分匹配 (年龄,种族,并发症,感染源) 用于均衡的风险因素分析.
- 收集有关人口统计,并发病,生命体征,实验室值,药物,ICU入院,机械呼吸和死亡率 (30天,90天,1年) 的数据.
主要成果:
- 包括超过920,000名败血症患者;呼吸道感染在两性中最常见.
- 女性接受piperacillin-tazobactam,万科米辛和血管压缩剂的可能性较低,即使在调整尿路感染源之后.
- 女性在30天 (12.1%对13%),90天 (17.1%对18.7%) 和一年 (21.5%对23.3%) 的全因死亡率较低.
结论:
- 在多个时间点中,女性的败血症相关死亡率明显降低.
- 尽管死亡率较低,但女性接受的关键干预措施较少,如血管压缩剂和宽谱抗生素.
- 研究结果表明,在败血症管理中存在潜在的基于性别的差异,需要进一步调查.
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