男女之间的默默的代价在中枢手术:一个倾向-得分匹配分析
Leo Pölzl1, Ronja Lohmann1,2, Clemens Engler1
1Department of Cardiac Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria.
概括
患有 mitra 膜疾病的妇女在晚些时候出现复杂的病理,导致更低的修复率和更高的死亡率. 解决疾病形态,而不是性别,是改善结果的关键.
科学领域:
- 心血管外科心血管外科
- 心脏外科手术的结果
- 医学中的性别差异.
背景情况:
- 中枢 (MV) 疾病在表现和结果上表现出性别特异性差异.
- 患有MV疾病的女性往往晚些时候出现,更高的替代率和较差的生存率.
- 在MV手术中调查与性别相关的差异对于改善患者护理至关重要.
研究的目的:
- 为了调查与性相关的差异,在手术的手术方法中对 mitra 门手术.
- 为了比较进行MV手术的男性和女性患者之间的修复率和结果.
- 确定导致观察到的MV手术结果的性别差异的因素.
主要方法:
- 对1531名接受MV手术的患者进行了回顾性分析.
- 性别之间的基线特征,操作策略和结果的比较.
- 倾向性得分匹配以调整基线差异,并分析死亡率和修复率.
主要成果:
- 女性患者年龄较大,症状较强,环状化率较高,并患有并发性三病.
- 卡蒂尔型IIIa MV疾病在女性中更为普遍,而II型在男性中占主导地位.
- 在女性中观察到的微创MV手术 (MIMVS) 和修复率较低,与30天和5年死亡率的增加有关.
结论:
- 女性呈现更复杂的MV病理,导致更低的修复和MIMVS率和更高的死亡率.
- 疾病形态,而不是性别本身,在很大程度上解释了这些差异.
- 为了改善外科手术结果,对患有MV疾病的妇女的早期转诊至关重要.
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