性别对因哮喘入院的成年人的影响。

The influence of gender on adults admitted for asthma.

作者信息

Woods Scott E, Brown Kelly, Engel Amy

机构信息

Bethesda Family Medicine Residency Program, Cincinnati, Ohio 45212, USA.

出版信息

Gend Med. 2010 Apr;7(2):109-14. doi: 10.1016/j.genm.2010.03.005.

DOI:10.1016/j.genm.2010.03.005

PMID:20435273

Abstract

BACKGROUND

In the United States, the prevalence of asthma is not only higher than in most other countries, it also varies greatly between diverse populations. Only limited data exist that examine the variation of outcomes by gender in patients admitted to a hospital for asthma.

OBJECTIVE

This study assessed outcome differences based on gender in adults who were admitted nationally with the primary diagnosis of asthma.

METHODS

A retrospective cohort study was conducted of all patients who were admitted to a hospital with the primary diagnosis of asthma in 2002-2005 and were reported in the Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project. Patients were excluded if they were aged <18 years or had an additional diagnosis of chronic obstructive pulmonary disease.

RESULTS

A total of 590,410 patients (439,991 women, 150,419 men) were included in the study. Patients admitted for asthma were significantly more likely to be female (P < 0.05). Women were significantly older compared with men (mean [SD], 48.5 [17.4] vs 44.6 [17.0] years, respectively), had a longer length of stay (3.44 vs 2.84 days), were more likely to be white (37.9% vs 34.2%), and had a higher total cost of admission ($10,575 vs $9390) (all, P < 0.05). Women were more likely than men to need a tracheostomy (adjusted odds ratio [AOR] = 2.04; 95% CI, 1.77-2.35) and to have a bronchoscopy (AOR =1.12; 95% CI, 1.05-1.21). Men were significantly more likely than women to have arterial blood gases performed (AOR = 1.15; 95% Cl, 1.05-1.27) and to be intubated (AOR = 1.18; 95% Cl, 1.10-1.26) (both, P < 0.05). Men were significantly more likely to be admitted as an emergency admission (AOR = 1.10; 95% Cl, 1.04-1.18) and to die during hospitalization (AOR =1.69; 95% CI, 1.41-2.03).

CONCLUSION

Although they were less likely to be admitted to a hospital, men were more likely to be admitted as an emergency and to experience worse outcomes compared with women, in this study of adults with asthma in the United States.

摘要

背景

在美国，哮喘的患病率不仅高于大多数其他国家，而且在不同人群之间差异很大。关于因哮喘住院患者的结局按性别差异的数据有限。

目的

本研究评估了以哮喘为主要诊断全国范围内住院的成年人中基于性别的结局差异。

方法

对2002年至2005年以哮喘为主要诊断住院并在医疗成本和利用项目的全国住院患者样本中报告的所有患者进行了一项回顾性队列研究。年龄<18岁或有慢性阻塞性肺疾病额外诊断的患者被排除。

结果

本研究共纳入590410例患者（439991例女性，150419例男性）。因哮喘住院的患者女性明显更多（P<0.05）。女性比男性年龄明显更大（平均[标准差]分别为48.5[17.4]岁和44.6[17.0]岁），住院时间更长（3.44天对2.84天），更可能是白人（37.9%对34.2%），住院总费用更高（10575美元对9390美元）（所有P<0.05）。女性比男性更需要气管切开术（调整优势比[AOR]=2.04；95%可信区间，1.77 - 2.35）和进行支气管镜检查（AOR =1.12；95%可信区间，1.05 - 1.21）。男性比女性更可能进行动脉血气分析（AOR =1.15；95%可信区间，1.05 - 1.27）和插管（AOR =1.18；95%可信区间，1.10 - 1.26）（两者P<0.05）。男性作为急诊入院的可能性明显更高（AOR =1.10；95%可信区间，1.04 - 1.18），且在住院期间死亡的可能性更高（AOR =1.69；95%可信区间，1.41 - 2.03）。