Assessment of the interaction of age and sex on 90-day outcome after intracerebral hemorrhage.
Assessment of the interaction of age and sex on 90-day outcome after intracerebral hemorrhage.
复制标题
DOI：
10.1212/wnl.0000000000004255
复制
发表时间：
2017-09-05
期刊：
影响因子：
9.9
通讯作者：
ERICH Investigators
中科院分区：
文献类型：
--
作者：
James ML;Langefeld CD;Sekar P;Moomaw CJ;Elkind MSV;Worrall BB;Sheth KN;Martini SR;Osborne J;Woo D;ERICH Investigators
由于年龄对女性荷尔蒙产生的影响与男性不同，因此我们试图定义脑出血（ICH）后多种族/民族人群中性别和年龄的相互作用，以发现性腺激素产生丧失将导致性腺激素已知的神经保护作用丧失的证据。使用了 2013 年 12 月之前参加脑出血研究的民族/种族差异以及出血性中风的遗传和环境风险因素研究的参与者的临床和放射学数据。使用多变量逻辑回归分析评估了 616 名非西班牙裔黑人、590 名西班牙裔和 868 名非西班牙裔白人参与者的性别、年龄和 ICH 后结果之间的关系。不良结果定义为 ICH 后 90 天改良 Rankin 量表评分≥3。在种族/族裔群体中的多个变量中发现了性别差异，包括发病年龄、病前神经系统状态和脑出血后的神经系统结果。总体而言，ICH后90天的死亡率（p = 0.183）或改良Rankin量表评分（p = 0.378）没有发现性别-年龄交互作用。在种族/族裔亚组中，只有非西班牙裔黑人队列在 90 天改良兰金量表评分上提供了性别-年龄相互作用的可能证据 (p = 0.003)。与缺血性中风不同，没有证据表明在大量多种族/民族人群中，患者性别会改变年龄对 ICH 后 90 天结果的影响。未来的研究应该评估中风亚型之间这些差异的生物学原因。 NCT01202864。
Because age affects hormonal production differently in women compared with men, we sought to define sex and age interactions across a multiracial/ethnic population after intracerebral hemorrhage (ICH) to uncover evidence that loss of gonadal hormone production would result in loss of the known neuroprotective effects of gonadal hormones. Clinical and radiographic data from participants in the Ethnic/Racial Variations of Intracerebral Hemorrhage study and the Genetic and Environmental Risk Factors for Hemorrhagic Stroke study prior to December 2013 were used. Relationships among sex, age, and outcome after ICH in 616 non-Hispanic black, 590 Hispanic, and 868 non-Hispanic white participants were evaluated using multivariable logistic regression analysis. Poor outcome was defined as modified Rankin Scale score ≥3 at 90 days after ICH. Sex differences were found in multiple variables among the racial/ethnic groups, including age at onset, premorbid neurologic status, and neurologic outcome after ICH. Overall, no sex–age interaction effect was found for mortality (p = 0.183) or modified Rankin Scale score (p = 0.378) at 90 days after ICH. In racial/ethnic subgroups, only the non-Hispanic black cohort provided possible evidence of a sex–age interaction on 90-day modified Rankin Scale score (p = 0.003). Unlike in ischemic stroke, there was no evidence that patient sex modified the effect of age on 90-day outcomes after ICH in a large multiracial/ethnic population. Future studies should evaluate biological reasons for these differences between stroke subtypes. NCT01202864.