Gender differences in acute stroke treatment: the University of California San Diego experience.
Gender differences in acute stroke treatment: the University of California San Diego experience.
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急性中风治疗中的性别差异：加州大学圣地亚哥分校的经验。
DOI：
10.1161/strokeaha.110.584136
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发表时间：
2010
期刊：
影响因子：
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通讯作者：
Hemmen,ThomasM
中科院分区：
文献类型：
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作者：
Tafreshi,GildaM;Raman,Rema;Ernstrom,Karin;Meyer,BrettC;Hemmen,ThomasM
背景与目的：评价急性缺血性脑卒中患者使用和不使用组织纤溶酶原激活剂治疗的性别差异。主要目的是评估基线风险因素、治疗时间和90天结果的差异。关于急性卒中治疗中性别差异的数据显示，女性卒中患者延迟治疗和评估与较差的预后相关。方法-回顾2001年至2009年加州大学圣地亚哥分校急性卒中转化研究专业项目（SPOTRIAS）数据库。所有入院诊断为急性缺血性脑卒中的“码脑卒中”患者按性别及组织型纤溶酶原激活剂治疗进行分类（1组使用组织型纤溶酶原激活剂，2组未使用）。结果：共纳入848例患者，第1组294例，基线NIHSS中位数和平均年龄男性为10岁和67.6±16.5岁，女性为13岁和72.4±16.5岁。组2:554例患者，基线NIHSS中位数和平均年龄男性为4岁和68.4±14.0岁，女性为5岁和72.2±14.0岁。女性和男性的组织纤溶酶原激活剂治疗率相似（女性=38%，男性=32%）。男性吸烟和有冠状动脉病史的可能性更大，有房颤病史的可能性更小。在两组中，男性的90天改良Rankin量表评分为0到1的比例高于女性（1组为35.5%比22.6%；2组为57.3%比47.3%）。多变量分析调整观察到的混杂因素，即入院NIHSS、冠状动脉疾病/心肌梗死和心房颤动，表明这种差异无统计学意义。在评估两组患者的治疗时间时，我们发现性别之间没有显著差异。结论：急性缺血性脑卒中患者的治疗时间和治疗后的预后在性别上是相似的。在我们的样本中没有发现先前确定的卒中治疗时间和结果的性别差异。
Background and Purpose—To assess the gender differences in patients with acute ischemic stroke treated with and without tissue plasminogen activator. The primary purpose is to evaluate for differences in baseline risk factors, treatment times, and 90-day outcomes. Data regarding gender differences in acute stroke treatment shows a delayed treatment and evaluation in women with stroke, associated with poorer outcome.Methods—Review of the University of California San Diego Specialized Program for Translational Research in Acute Stroke (SPOTRIAS) database from 2001 to 2009. All “code stroke” patients with the admitting diagnosis of acute ischemic stroke were classified based on gender and tissue plasminogen activator treatment (group 1 with tissue plasminogen activator, group 2 without).Results—A total of 848 patients were included, group 1: 294 patients, baseline median NIHSS and mean age in men was 10 and 67.6±16.5 years, in women 13 and 72.4±16.5 years. group 2: 554 patients, baseline median NIHSS and mean age in men was 4 and 68.4±14.0 years, in women 5 and 72.2±14.0 years. Women and men had a similar tissue plasminogen activator treatment rate (women=38%, men=32%). Men were more likely to use tobacco and have a history of coronary artery disease and less likely to have a history of atrial fibrillation. In both groups, men had higher rates of a 90-day modified Rankin scale score of 0 to 1 compared to women (group 1 35.5% vs 22.6%; group 2 57.3% vs 47.3%). Multivariable analysis adjusting for observed confounders, namely admission NIHSS, coronary artery disease/myocardial infarction, and atrial fibrillation, indicate that this difference was not statistically significant. We found no significant difference between genders when assessing for treatment times in either group.Conclusions—Treatment times and patient outcomes after treatment for acute ischemic stroke were similar between genders. Previously identified gender differences in stroke treatment times and outcome were not found in our sample.