Sex-Based Differences in Discharge Disposition and Outcomes for ST-Segment Elevation Myocardial Infarction Patients Within a Regional Network
Sex-Based Differences in Discharge Disposition and Outcomes for ST-Segment Elevation Myocardial Infarction Patients Within a Regional Network
复制标题
DOI：
10.1089/jwh.2017.6553
复制
发表时间：
2018-01-10
影响因子：
3.5
通讯作者：
Jacobs, Alice K.
中科院分区：
文献类型：
--
作者：
Langabeer, James R., II;Henry, Timothy D.;Jacobs, Alice K.
背景：众所周知，女性ST段抬高型心肌梗死（STEMI）的死亡率高于男性。虽然这种基于性别的差异的原因尚不完全清楚，但生物差异和护理差异已被牵连在内。这些差异是否持续存在于城市，区域STEMI护理系统与定义的协议尚不清楚。我们的目标是探索在一个大型的区域护理系统的结果与性别有关的影响。材料与方法：数据来自2010年至2015年德克萨斯州达拉斯县及其周边33家医院的国家心血管数据登记处的区域子集。我们探讨了女性和男性在出院处置、门到球囊（D2 B）、总缺血时间（TIS）、住院时间和住院死亡率方面的调整后差异。结果如下：控制混杂因素（包括年龄、D2 B和TIS）的多变量回归分析显示，与男性相比，女性的D2 B 58分钟对54分钟; TIS 206分钟对178分钟;两者均显著延长。
Background: It is known that women with ST-segment elevation myocardial infarction (STEMI) have higher mortality in comparison to men. While the reasons for this sex-based difference are not completely understood, biologic differences and disparities in care have been implicated. Whether these differences persist within an urban, regional STEMI system of care with defined protocols is unclear. Our objective was to explore sex-related effects in outcomes in a large regional system of care. Materials and Methods: Data were drawn from a regional subset of the National Cardiovascular Data Registry for 33 hospitals in and around Dallas County, Texas from 2010 to 2015. We explored adjusted differences between women and men for discharge disposition, door to balloon (D2B), total ischemic time (TIS), length of stay, and in-hospital mortality rates. Results: Multivariate regressions to control for confounding factors, including age, D2B, and TIS, were significantly prolonged in women compared to men (D2B 58 vs. 54 minutes; TIS 206 vs. 178 minutes; both p