Houde Stefanie, Feldman Debbie Ehrmann, Pilote Louise, Beck Eduard J, Giannetti Nadia, Frenette Marc, Ducharme Anique
Université de Montréal, Montréal, Canada.
Can J Cardiol. 2007 May 1;23(6):451-5. doi: 10.1016/s0828-282x(07)70783-3.
Specialized, multidisciplinary clinics improve service provision and reduce morbidity for patients with congestive heart failure (CHF). Although sex-related differences in access to cardiac health services have been reported, it remains unclear whether there are sex-related differences in the use of these specialized services.
To evaluate possible sex-related differences in severity at entry into specialized, multidisciplinary clinics, and compare prescription patterns between male and female patients at these clinics.
Data were obtained from the electronic clinical files of 765 CHF patients newly admitted to any of three main CHF clinics in Montreal, Quebec. Univariate and multivariate models were used to compare differences between sexes.
Only 27.1% of patients were female. The mean age (+/- SD) of the women in the present study was similar to that of the men (64+/-16 years versus 65+/-13 years, respectively). Left ventricular ejection fraction at entry for patients with reduced systolic function was comparable between sexes. The New York Heart Association functional class at entry was similar among men and women with systolic dysfunction. However, among patients with preserved systolic function, women were more symptomatic, with a higher functional class at entry (adjusted OR 2.52, 95% CI 1.18 to 5.38). Prescription profiles were similar for men and women.
Entry into a clinic may be delayed for women with preserved systolic function CHF. However, clinic referral patterns and disease management appeared to be similar among both men and women with systolic dysfunction CHF.
专业的多学科诊所可改善充血性心力衰竭（CHF）患者的服务提供并降低发病率。尽管已有报道称在获得心脏健康服务方面存在性别差异，但这些专业服务的使用是否存在性别差异仍不清楚。
评估进入专业多学科诊所时严重程度方面可能存在的性别差异，并比较这些诊所中男性和女性患者的处方模式。
数据来自魁北克省蒙特利尔市三家主要CHF诊所新收治的765例CHF患者的电子临床档案。采用单变量和多变量模型比较性别差异。
仅27.1%的患者为女性。本研究中女性的平均年龄（±标准差）与男性相似（分别为64±16岁和65±13岁）。收缩功能降低患者入院时的左心室射血分数在性别之间具有可比性。收缩功能障碍患者入院时的纽约心脏协会功能分级在男性和女性中相似。然而，在收缩功能保留的患者中，女性症状更明显，入院时功能分级更高（校正比值比2.52，95%置信区间1.18至5.38）。男性和女性的处方概况相似。
收缩功能保留的CHF女性患者进入诊所的时间可能会延迟。然而，收缩功能障碍CHF的男性和女性患者的诊所转诊模式和疾病管理似乎相似。
