Diagnostic Evaluation for Patients with Ischemic Stroke: Are There Sex Differences?
Diagnostic Evaluation for Patients with Ischemic Stroke: Are There Sex Differences?
复制标题
DOI：
10.1159/000209240
复制
发表时间：
2009-01-01
影响因子：
2.9
通讯作者：
Lichtman, Judith H.
中科院分区：
文献类型：
--
作者：
Watanabe, Emi;Allen, Norrina B.;Lichtman, Judith H.
背景与目的：有大量文献记载了女性和男性急性冠状动脉症状管理的差异，但对缺血性卒中患者的实践知之甚少。我们试图确定在美国学术医院接受治疗的缺血性卒中患者诊断测试的使用是否存在性别相关差异。研究方法：从2004年1月到6月，作为大学健康系统联盟缺血性卒中基准项目的一部分，我们提取了32个美国学术医疗中心连续收治的缺血性卒中患者的病历。我们比较了女性和男性的诊断测试的使用率，包括神经影像学（CT或MRI），心电图（ECG），颈动脉超声和超声心动图（经胸或经食管）。多变量逻辑回归用于检验性别差异，并调整潜在混杂因素。结果：该研究包括1,256名缺血性卒中患者（611名女性; 645名男性;平均年龄66.6 ± 14.6岁; 56%为白色）。在神经影像学的使用方面，女性和男性之间没有差异（OR = 1.37; 95%置信区间，CI = 0.58-3.24），ECG（OR = 1.00，95% CI = 0.70-1.44）、颈动脉超声（OR = 0.93，95% CI = 0.72-1.21）或超声心动图（OR = 0.70，95% CI = 0.70-1.22）。协变量调整后结果相似。结论：美国学术医院收治的女性和男性接受了可比的诊断评估，即使在调整了社会人口和临床因素之后。版权所有（C）2009 S. Karger AG，巴塞尔
Background and Purpose: Differences in the management of women and men with acute coronary symptoms are well documented, but relatively little is known about practices for patients with ischemic stroke. We sought to determine whether there are sex-associated differences in the utilization of diagnostic tests for ischemic stroke patients treated at academic hospitals in the United States. Methods: Medical records were abstracted for consecutive ischemic stroke patients admitted to 32 US academic medical centers from January through June, 2004, as part of the University Health-System Consortium Ischemic Stroke Benchmarking Project. We compared the utilization rates of diagnostic tests including neuroimaging (CT or MRI), electrocardiogram (ECG), ultrasound of the carotid arteries, and echocardiography (transthoracic or transesophageal) for women and men. Multivariate logistic regression was used to test for sex differences with adjustment for potential confounders. Results: The study included 1,256 ischemic stroke patients (611 women; 645 men; mean age 66.6 +/- 14.6 years; 56% white). There were no differences between women and men in the use of neuroimaging (odds ratio, OR = 1.37; 95% confidence interval, CI = 0.58-3.24), ECG (OR = 1.00, 95% CI = 0.70-1.44), carotid artery ultrasound (OR = 0.93, 95% CI = 0.72-1.21) or echocardiography (OR = 0.70, 95% CI = 0.70-1.22). The results were similar after covariate adjustment. Conclusions: Women and men admitted to US academic hospitals receive comparable diagnostic evaluations, even after adjusting for sociodemographic and clinical factors. Copyright (C) 2009 S. Karger AG, Basel