Jiang Yanming, Sheikh Kazim, Bullock Claudia
U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, Kansas City, Missouri, USA.
J Stroke Cerebrovasc Dis. 2006 Sep-Oct;15(5):179-86. doi: 10.1016/j.jstrokecerebrovasdis.2006.05.007.
We sought to confirm previous studies for the presence and direction of sex and race difference in stroke mortality.
Administrative data for 40,450 Medicare beneficiaries who were hospitalized in 1994 to 1996 with acute stroke were used in regression analyses to study sex and race differences in 1-year all-cause mortality among patients with different types of stroke and cause-specific mortality in patients with all types of stroke combined. Hazard ratios were adjusted for age, sex or race, state, year of index stroke, past stroke, subsequent stroke, and fatal coexisting conditions excluding cerebrovascular diseases.
Men with ischemic cerebral infarction, nonspecific stroke, or all types of stroke combined were at 21% to 35% higher risk of all-cause mortality than women, but there was no sex difference among patients with subarachnoid or intracerebral hemorrhage. Nonwhite patients with ischemic cerebral infarction had 11% higher all-cause mortality than white patients, but there were no race differences after adjustments for fatal coexisting conditions. Compared with women, mortality was higher in men with all types of stroke regardless of the cause of death. There was higher risk of death caused by cerebrovascular diseases in white patients with all types of stroke combined, but the risk of death caused by cardiovascular diseases other than ischemic heart disease was higher in nonwhite patients.
There was no sex or race difference in all-cause mortality in patients with hemorrhagic stroke and higher risk in men with ischemic and nonspecific stroke. Relatively higher risk of mortality caused by cerebrovascular diseases was found in men and white patients.
我们试图证实先前关于中风死亡率中性别和种族差异的存在及方向的研究。
对1994年至1996年因急性中风住院的40450名医疗保险受益人的行政数据进行回归分析，以研究不同类型中风患者1年全因死亡率的性别和种族差异，以及所有类型中风合并患者的死因特异性死亡率。风险比针对年龄、性别或种族、州、首次中风年份、既往中风、后续中风以及排除脑血管疾病的致命共存疾病进行了调整。
患有缺血性脑梗死、非特异性中风或所有类型中风合并的男性，其全因死亡率比女性高21%至 35%，但蛛网膜下腔出血或脑出血患者中不存在性别差异。患有缺血性脑梗死的非白人患者全因死亡率比白人患者高11%，但在对致命共存疾病进行调整后不存在种族差异。与女性相比，无论死因如何，患有所有类型中风的男性死亡率更高 。所有类型中风合并的白人患者因脑血管疾病导致的死亡风险更高，但非白人患者因缺血性心脏病以外的心血管疾病导致的死亡风险更高。
出血性中风患者的全因死亡率不存在性别或种族差异，缺血性和非特异性中风男性的风险更高。男性和白人患者因脑血管疾病导致的死亡风险相对较高。
