Gender differences in in-hospital management and outcomes in patients with decompensated heart failure: Analysis from the acute decompensated heart failure national registry (ADHERE)
Gender differences in in-hospital management and outcomes in patients with decompensated heart failure: Analysis from the acute decompensated heart failure national registry (ADHERE)
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DOI：
10.1016/j.cardfail.2005.09.005
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发表时间：
2006-03-01
影响因子：
6
通讯作者：
Moskowitz, RM
中科院分区：
文献类型：
--
作者：
Galvao, M;Kalman, J;Moskowitz, RM
背景资料：急性失代偿性心力衰竭（ADHF）住院患者中性别差异的影响尚未得到很好的描述。方法和结果：通过回顾病历，根据性别对105,388例患者病历的特征、治疗和结局数据进行分析。女性占52%，年龄比男性大（74.5岁对70.1岁），更常见的是保留了左心室功能（51%对28%）。根据病史，女性患冠状动脉疾病及其危险因素的可能性较低（51%对64%），但高血压更常见（76%对70%）。两种性别接受相似的静脉利尿剂方案，但较少的女性接受血管活性药物治疗（24% vs 31%）。循证口服疗法在两种性别中均未得到充分利用。妇女始终接受较少的程序导向的治疗。平均住院时间（女性5.9天，男性5.8天）和风险调整后的住院死亡率（调整后的比值比0.974 [0.910-1.042]，P = 0.4390）在两种性别中相似。心力衰竭伴左心室功能保留多见于女性。虽然妇女受到的治疗不那么积极，但男女之间都存在治疗差距。尽管存在这些差异，但住院时间和住院死亡率相似。
Background: The impact of gender differences has not been well described in patients hospitalized with acute decompensated heart failure (ADHF).Methods and Results: Through review of medical records, data on characteristics, treatments, and outcomes were analyzed on 105,388 patient records according to gender. Women accounted for 52% of these admissions and were older than men (74.5 versus 70.1 years,) and more commonly had preserved left ventricular function (51% versus 28%). Based on history, women were less likely to have coronary artery disease (51% versus 64%) and its risk factors, but more commonly had hypertension (76% versus 70%). Both genders received similar intravenous diuretic regimens, but fewer women received vasoactive therapy (24% vs 31%). Evidence-based oral therapies were underused in both genders. Women consistently received less procedure-oriented therapy. Mean length of stay (women 5.9, men 5.8 days) and the risk-adjusted in-hospital mortality (adjusted odds ratio 0.974 [0.910-1.042], P = .4390) were similar in both genders.Conclusion: More women than men are hospitalized with ADHF. Heart failure with preserved left ventricular function predominates in women. Though women are treated less aggressively, treatment gaps exists in both sexes. Despite these differences, length of stay and in-hospital mortality rates are similar.