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种族对蛛网膜下腔出血预后的影响。

The influence of race on outcome following subarachnoid hemorrhage.

机构信息

Department of Neurological Surgery, Columbia University, 710 West 168th Street, New York, New York 10032, USA.

出版信息

J Clin Neurosci. 2010 Jan;17(1):34-7. doi: 10.1016/j.jocn.2009.05.015. Epub 2009 Dec 8.

Abstract

The goal of this study was to examine the relationship between race and outcome following subarachnoid hemorrhage (SAH). We identified all SAH discharges in New York City during 2003. An adverse outcome was defined as in-hospital death or discharge other than to home. While correcting for age and gender, we examined the effect of race and payor status on outcome following SAH. Forty-four percent of patients with SAH were white. Being white had a significant relationship with outcome when controlled for payor status (odds ratio 0.56). Among self-pay/Medicaid patients, fewer white (52%) individuals suffered poor outcomes than non-white (66%, p=0.03). Our results establish that white patients in New York City with SAH have better outcomes than non-whites. While it is unclear whether this discrepancy is secondary to pathophysiological differences or unidentified social factors, our findings demonstrate that this effect is independent of insurance status, and emphasize the need for further investigation into racial disparities in outcome following SAH.

摘要

本研究旨在探讨蛛网膜下腔出血(SAH)后种族与结局的关系。我们确定了 2003 年期间纽约市所有的 SAH 出院患者。不良结局定义为住院期间死亡或出院而非返家。在校正年龄和性别后,我们研究了种族和支付者身份对 SAH 后结局的影响。44%的 SAH 患者为白人。在控制支付者身份后,白人种族与结局有显著关系(比值比 0.56)。在自费/医疗补助患者中,白人(52%)不良结局的比例低于非白人(66%,p=0.03)。我们的结果表明,纽约市的 SAH 白人患者比非白人患者的结局更好。尽管尚不清楚这种差异是继发于病理生理差异还是未识别的社会因素,但我们的研究结果表明,这种影响独立于保险状况,并强调需要进一步研究 SAH 后结局的种族差异。

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