Assessment of Sex Differences for Treatment, Procedures, Complications, and Associated Conditions Among Adolescents Hospitalized with Crohn's Disease.
Assessment of Sex Differences for Treatment, Procedures, Complications, and Associated Conditions Among Adolescents Hospitalized with Crohn's Disease.
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DOI：
10.1097/mib.0000000000000521
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发表时间：
2015-11
影响因子：
4.9
通讯作者：
Crandall WV
中科院分区：
文献类型：
--
作者：
Dotson JL;Bricker JB;Kappelman MD;Chisolm D;Crandall WV
已报告了成人在医疗保健治疗和结局方面的性别差异，但是，关于儿科人群，特别是克罗恩病（CD）青少年的文献很少。目的是确定住院青少年CD患者在并发症、手术和药物使用（皮质类固醇、生物制剂和全胃肠外营养（TPN））方面是否存在性别差异。从儿科健康信息系统数据库中选择2004年4月1日至2012年6月30日期间住院的CD青少年（n=5782），各医院的男女比例为1：1。采用非参数统计检验分析疾病并发症、相关疾病、手术和药物使用的频率是否存在性别差异。纳入5782例患者，中位年龄为15岁。女性患贫血（29% vs. 25%，p=0.012）、感染（12% vs. 8%，p=0.001）和情绪障碍（9% vs. 6%，p<0.001）的可能性略高，而男性则有更多的成熟延迟（3% vs. 1%，p=0.004）和营养不良（18% vs. 14%，p=0.027）。在这些操作中，只有一个类别显示出性别差异：女性有更多的血液制品输注（9% vs. 6%，p<0.001）。女性皮质类固醇（62%）、生物制剂（16%）和TPN（18%）的使用率与男性（分别为62%、15%和20%）无统计学差异。在住院时间方面，性别没有差异。这一横断面研究的行政数据库确定了一些青少年CD的性别差异。效应量普遍较小，且通常与已知的与IBD无关的性别差异一致。
Sex differences among adults in healthcare treatment and outcomes have been reported, however, there is a paucity of literature regarding pediatric populations, particularly adolescents with Crohn’s disease (CD). The objective was to identify whether sex differences exist with respect to complications, procedures, and medication usage (corticosteroids, biologic agents, and total parenteral nutrition (TPN)) among hospitalized adolescents with CD. Adolescents with CD (n=5782) hospitalized between April 1, 2004–June 30, 2012 were selected from the Pediatric Health Information System database with a 1:1 ratio of males to females by hospital. Frequency of disease complications, associated conditions, procedures performed, and medication usage were analyzed with non-parametric statistical tests for the existence of sex differences. 5782 patients were included with a median age of 15 years. Females were slightly more likely to have anemia (29% vs. 25%, p=0.012), infection (12% vs. 8%, p=0.001), and mood disorder (9% vs. 6%, p<0.001), whereas males had more maturational delays (3% vs. 1%, p=0.004), and malnutrition (18% vs. 14%, p=0.027). Among procedures, only one category demonstrated a sex difference: females had more blood product transfusions (9% vs. 6%, p<0.001). Female rates for corticosteroids (62%), biologic agents (16%) and TPN (18%) were not statistically different from those for males (62%, 15%, and 20%, respectively). There were no differences in length of stay by sex. This cross-sectional study of an administrative database identified few sex differences among adolescents with CD. The effect sizes were universally small and generally consistent with known sex differences unrelated to IBD.