Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.
Eur J Vasc Endovasc Surg. 2011 Oct;42(4):510-6. doi: 10.1016/j.ejvs.2011.06.029. Epub 2011 Jul 26.
The objective was to evaluate the impact of gender on long-term survival of patients who underwent non-cardiac vascular surgery.
DESIGN, MATERIAL AND METHODS: Our prospectively collected data contained information on 560 patients undergoing carotid endarterectomy (CEA), 923 elective abdominal aortic aneurysm repairs (AAA) and 1046 lower limb reconstructions (LLR). Patient characteristics and long-term mortality of women were compared to that of men. Kaplan-Meier (KM) survival curves were constructed for men and women, on which we superimposed age- and sex-matched KM survival curves of the general population. Cox proportional hazards regression was used to identify risk factors for mortality.
Men in the CEA group had statistically significant higher all-cause mortality, hazard rate ratio (HRR) 1.41 (95% CI 1.01-1.98) No differences in mortality between the genders were observed in the AAA and LLR groups. Overall, men had more co-morbidities but received more disease-specific medication compared to women. Women retained their higher life expectancy after CEA but lost it in the AAA and LLR groups.
Women retain their higher life expectancy after CEA; however, after AAA repair and LLR, this advantage is lost. Both men and women received too little disease-specific medication, but women were worse off.
评估性别对非心脏血管手术患者长期生存的影响。
设计、材料和方法:我们前瞻性收集的数据包含了 560 例颈动脉内膜切除术(CEA)、923 例择期腹主动脉瘤修复术(AAA)和 1046 例下肢重建术(LLR)患者的信息。将女性患者的特征和长期死亡率与男性进行比较。为男性和女性绘制 Kaplan-Meier(KM)生存曲线,并在其上叠加一般人群中年龄和性别匹配的 KM 生存曲线。使用 Cox 比例风险回归来确定死亡率的危险因素。
CEA 组男性的全因死亡率有统计学意义,危险率比(HRR)为 1.41(95%置信区间 1.01-1.98)。AAA 和 LLR 组中,两性之间的死亡率无差异。总体而言,男性的合并症更多,但接受的疾病特异性药物治疗比女性更多。女性在 CEA 后保持较高的预期寿命,但在 AAA 和 LLR 组中失去了这一优势。
女性在 CEA 后仍保持较高的预期寿命;然而,在接受 AAA 修复和 LLR 后,这种优势就消失了。男性和女性都接受了太少的疾病特异性药物治疗,但女性的情况更糟。