在急性肢体缺血后,女性患者的不良结果风险增加
Mikayla N Lowenkamp1, Marissa C Jarosinski1, Kevin Li2
1University of Pittsburgh Medical Center, Division of Vascular Surgery, Pittsburgh, PA.
Journal of vascular surgery
|August 28, 2025
概括
女患者急性四肢缺血 (ALI) 面临更高的死亡率后再血管,特别是在内血管手术. 医疗优化改善了女性的结果,表明需要针对性别的治疗策略.
科学领域:
- 血管外科
- 心血管医学
- 健康上的差异
背景情况:
- 女性患者在临床试验中代表性不足,导致血管疾病的性别指南缺乏.
- 现有文献显示,急性肢体缺血 (ALI) 治疗的女性患者的截肢和死亡率存在差异.
研究的目的:
- 鉴定ALI重血管化的重大截肢和死亡率的性别特异性预测因素.
- 调查针对ALI进行重血管化的患者表现,治疗和治疗结果的性别差异.
主要方法:
- 从2016年至2023年接受ALI重血管化的成年患者的回顾性分析.
- 排除患有创伤,解剖,阳性损伤,骨动脉瘤或COVID相关的ALI的患者.
- 用Kaplan- Meier和多变量Cox回归分析来评估生存率和截肢率,并进行子组分析.
主要成果:
- 女性患者 (46%) 的死亡率较高 (aHR=1. 6),并且不太可能服用手术前的他类药物或抗血小板药物.
- 虽然整体截肢率相似,但接受内血管干预的女性截肢率翻了一番 (OR 2. 6).
- 在医学上优化的女性患者的死亡率与男性相似.
结论:
- 患有ALI的女性患者在重血管化后死亡率较高,除非医疗优化.
- 在内血管治疗后观察到女性的截肢率更高,这突显了基于性别的显著差异.
- 进一步研究这些差异对于制定针对性别的干预策略至关重要.
相关概念视频
Peripheral Artery Disease V: Postoperative Nursing Management
24
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
24
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
34
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
34
Peripheral Artery Disease I: Introduction
32
Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
32
Cardiac Catheterization I: Pre-Procedure Overview
153
Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
153
Peripheral Artery Disease IV: Nursing Management
43
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
43
Cardiac Catheterization IV: Nursing Management
193
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
193


