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[纳瓦拉急性冠状动脉综合征患者治疗及预后的性别差异]

[Gender differences in the treatment and outcome of patients with acute coronary syndrome in Navarre].

作者信息

Ferraz-Torres M, Belzunegui Otano T, Marín Fernández B, Martínez-García O, Jiménez Fábregas X

机构信息

Servicio de Urgencias, Complejo Hospitalario de Navarra, Pamplona, 31008, Spain.

出版信息

An Sist Sanit Navar. 2014 May-Aug;37(2):249-55. doi: 10.4321/s1137-66272014000200008.

Abstract

BACKGROUND

Gender-based approaches have revealed the differing prevalence, incidence, progression and mortality of acute coronary disease by sex. This study aims to determine the difference by sex in the treatment and outcomes of patients with acute coronary syndrome (ACS) in Navarre.

METHODS

Thirty-five variables were analysed from 130 users with acute coronary disease who attended the Navarre Hospital (CHN) emergency department consecutively from January to April 2012. The dependent variable was sex and independent variables were time, treatments and final outcome of the process.

RESULTS

Males accounted for 74.6% of the sample, with a mean age of 67, which was less than the mean age of 72 for the female patients (p = 0.043). The median for cardiovascular risk factors was three in men and two in women (p = 0.026). The patient delay in seeking health care was 161 minutes in men compared to 266 minutes in women (p = 0.006). Treatment via revascularization by primary angioplasty or fibrinolysis was performed in 71.6% of men and 41.2% of women (p = 0.002). A 5.9% death rate was registered for women, with no deaths among the men (p = 0.017).

CONCLUSIONS

In Navarre, acute coronary syndrome remains more prevalent among men yet more severe in women. Treatment differs according to gender. Greater delay in seeking health care is observed among women, as is self-discharge from hospital, which may contribute to their less favourable outcomes.

摘要

背景

基于性别的研究方法揭示了急性冠状动脉疾病在患病率、发病率、病程进展及死亡率方面存在性别差异。本研究旨在确定纳瓦拉地区急性冠状动脉综合征(ACS)患者在治疗及预后方面的性别差异。

方法

对2012年1月至4月期间连续就诊于纳瓦拉医院(CHN)急诊科的130例急性冠状动脉疾病患者的35项变量进行分析。因变量为性别,自变量为时间、治疗方法及治疗最终结果。

结果

男性占样本的74.6%,平均年龄为67岁,低于女性患者的平均年龄72岁(p = 0.043)。男性心血管危险因素的中位数为3项,女性为2项(p = 0.026)。男性寻求医疗救治的延迟时间为161分钟,女性为266分钟(p = 0.006)。71.6%的男性和41.2%的女性接受了通过直接血管成形术或纤维蛋白溶解进行的血运重建治疗(p = 0.002)。女性的死亡率为5.9%,男性无死亡病例(p = 0.017)。

结论

在纳瓦拉地区,急性冠状动脉综合征在男性中更为普遍,但在女性中病情更为严重。治疗方法因性别而异。女性寻求医疗救治的延迟时间更长,且存在自行出院的情况,这可能导致其预后较差。

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