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性别影响高血压创伤患者的结局。

Gender influences outcomes in trauma patients with elevated systolic blood pressure.

机构信息

Department of Surgery, Division of Trauma and Critical Care, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.

出版信息

Am J Surg. 2011 Dec;202(6):823-7; discussion 828. doi: 10.1016/j.amjsurg.2011.06.044.

Abstract

BACKGROUND

This analysis explored the association between gender and systolic blood pressure (SBP) in trauma patients and then established how gender influenced outcomes in those with elevated SBP.

METHODS

Demographics and outcomes were compared using the Los Angeles County Trauma System Database and multivariable modeling determined predictors for SBP, pneumonia, and mortality.

RESULTS

Age and male sex were significant predictors for increased SBP, whereas the Injury Severity Score (ISS) ≥16 was a significant predictor for decreased SBP. In both male and female TBI patients, SBP ≥160 mmHg was associated with increased pneumonia (Adjusted odds ratio [AOR] = 1.74, P = .002 and AOR = 2.37, P = .046, respectively), whereas SBP ≥160 mmHg was a predictor for mortality only among male TBI patients (AOR = 1.48, P = .03). In non-TBI patients, SBP ≥160 mmHg was not a predictor for pneumonia or mortality in either sex.

CONCLUSIONS

In this retrospective review of trauma registry data, men presented with higher SBP. In patients with TBI, regardless of gender, increased SBP was associated with increased pneumonia, and in men with TBI increased SBP was associated with increased mortality. The cause and relevance of these epidemiological findings require further investigation.

摘要

背景

本分析探讨了创伤患者性别与收缩压(SBP)之间的关系,然后确定了性别如何影响 SBP 升高患者的结局。

方法

使用洛杉矶县创伤系统数据库比较人口统计学和结局,并进行多变量建模以确定 SBP、肺炎和死亡率的预测因素。

结果

年龄和男性是 SBP 升高的显著预测因素,而损伤严重程度评分(ISS)≥16 是 SBP 降低的显著预测因素。在男性和女性 TBI 患者中,SBP≥160mmHg 与肺炎发生率增加相关(校正优势比[OR] = 1.74,P=0.002 和 OR = 2.37,P=0.046),而 SBP≥160mmHg 仅是男性 TBI 患者死亡的预测因素(OR = 1.48,P=0.03)。在非 TBI 患者中,SBP≥160mmHg 不是男女患者肺炎或死亡的预测因素。

结论

在这项对创伤登记数据的回顾性研究中,男性的 SBP 较高。在 TBI 患者中,无论性别如何,SBP 升高与肺炎发生率增加相关,而在男性 TBI 患者中,SBP 升高与死亡率增加相关。这些流行病学发现的原因和相关性需要进一步研究。

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