Do men have a higher case fatality rate of severe acute respiratory syndrome than women do?
Do men have a higher case fatality rate of severe acute respiratory syndrome than women do?
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DOI：
10.1093/aje/kwh056
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发表时间：
2004-02-01
影响因子：
5
通讯作者：
Lai, WYY
中科院分区：
文献类型：
--
作者：
Karlberg, J;Chong, DSY;Lai, WYY
根据世界卫生组织的数据，严重急性呼吸综合征(SARS)已在30个国家和地区报告，截至2003年7月31日，累计疑似病例8,099例，死亡774例。在中华人民共和国中国的香港，截至二00三年九月二十二日，共有1,755宗严重急性呼吸系统综合症个案及299宗死亡个案。作者分析了来自香港特别行政区卫生署的数据。数据系列包括有关性别、年龄和慢性病病史的详细信息。利用2003年3月初至9月22日的数据，作者发现男性的病死率显著高于女性(P<；0.0001)，分别为21.9%和13.2%，相对危险度为1.66(95%可信区间：1.35，2.05)，调整年龄因素后为1.62(95%可信区间：1.21，2.16)。亚组分析排除医护人员(n=386)。总体粗略死亡相对危险度为1.41(95%CI：1.15，1.74)，调整后的相对危险度为1.48(95%CI：1.10，2.00)。因此，在SARS患者中，男性受疾病的影响可能比女性更严重。例如，这一发现可能与SARS疾病的不统一病例定义、不同的治疗方案、既往吸烟史、工作环境因素或性别特定的免疫防御因素有关。
Severe acute respiratory syndrome (SARS) has been reported in 30 countries and regions, with a cumulative total of 8,099 probable cases and 774 deaths as of July 31, 2003, according to the World Health Organization. In Hong Kong, People's Republic of China, 1,755 SARS cases and 299 deaths had occurred as of September 22, 2003. The authors analyzed data from the Department of Health, Hong Kong SAR. The data series includes details regarding sex, age, and chronic disease history. Using data from early March to September 22, 2003, the authors found that males had a significantly (p < 0.0001) higher case fatality rate than females did, 21.9% versus 13.2%; the relative risk was 1.66 (95% confidence interval (CI): 1.35, 2.05), and it was 1.62 (95% CI: 1.21, 2.16) after adjustment for age. Subgroup analysis was conducted by excluding health care workers (n = 386) from the analysis. The overall crude relative risk of mortality was 1.41 (95% CI: 1.15, 1.74), and the adjusted relative risk was 1.48 (95% CI: 1.10, 2.00). Thus, among SARS patients, males may be more severely affected by the disease than females are. This finding could be related to a nonuniform case definition of SARS disease, a different treatment regimen, a past smoking history, work-environment factors, or gender-specific immune-defense factors, for instance.