疾病严重程度和左心室心力衰竭结果的性别特异性差异:全国范围的队列研究
Anastasia Janina Hobbach1, Jannik Feld2, Jeanette Köppe2
1Department of Cardiology I, Peripheral Vascular Disease and Heart Failure University Hospital, Albert-Schweizer Campus 1, 48149, Münster, Germany. Anastasia.Hobbach@ukmuenster.de.
概括
性别和心力衰竭阶段显著影响左心室心力衰竭 (LVHF) 的结果和成本. 虽然女性的整体死亡率较高,但男性在大多数子组的结果较差,需要量身定制的管理策略.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
背景情况:
- 左心室心力衰竭 (LVHF) 是致病率和死亡率的主要原因.
- 现有的研究表明,在LVHF呈现和结果中,性别特异性差异很大.
- 根据纽约心脏协会 (NYHA) 分类的疾病严重程度对这些性别差异的影响尚未完全理解.
研究的目的:
- 调查性别和NYHA分类对LVHF患者临床结果的影响.
- 分析性别和NYHA分类对与LVHF住院治疗相关的医疗保健成本的影响.
- 确定 LVHF 患者住院死亡率的性别和阶段特定预测因素.
主要方法:
- 分析了2014-2022年德国LVHF住院病例的大数据集 (2.616.462例) 的分析.
- 根据性别和NYHA阶段的病例分层 (I-IV).
- 使用多变量后勤回归评估基线特征,并发病,住院结果 (包括死亡率) 和医疗保健成本.
主要成果:
- 女性在较早的NYHA阶段更常被诊断出患病,而男性在较晚的阶段占主导地位.
- 总体而言,女性 (8.34%) 的住院死亡率高于男性 (7.90%),但在大多数年龄和NYHA子组中,男性的死亡率更高.
- 尽管住院时间较短,但在NYHA III和IV阶段,男性的医疗费用较高. NYHA阶段是最强的死亡率预测因素,而女性性别和肥胖与较低的死亡率有关.
结论:
- 在LVHF中,临床结果和医疗费用受到性别和NYHA阶段的重大影响.
- 虽然女性的整体死亡率较高,但男性在特定子组的结果较差,突出了复杂的基于性别的模式.
- 调查结果强调,发展和实施特定于性别和阶段的LVHF管理策略至关重要.
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