Madsen Tracy E, Seigel Todd A, Mackenzie Richard S, Marcolini Evie G, Wira Charles R, Healy Megan E, Wright David W, Gentile Nina T
Department of Emergency Medicine, The Alpert Medical School of Brown University Rhode Island Hospital, Providence, RI.
Acad Emerg Med. 2014 Dec;21(12):1403-13. doi: 10.1111/acem.12528. Epub 2014 Nov 24.
Cerebrovascular neurologic emergencies including ischemic and hemorrhagic stroke, subarachnoid hemorrhage (SAH), and migraine are leading causes of death and disability that are frequently diagnosed and treated in the emergency department (ED). Although sex and gender differences in neurologic emergencies are beginning to become clearer, there are many unanswered questions about how emergency physicians should incorporate sex and gender into their research initiatives, patient evaluations, and overall management plans for these conditions. After evaluating the existing gaps in the literature, a core group of ED researchers developed a draft of future research priorities. Participants in the 2014 Academic Emergency Medicine consensus conference neurologic emergencies working group then discussed and approved the recommended research agenda using a standardized nominal group technique. Recommendations for future research on the role of sex and gender in the diagnosis, treatment, and outcomes pertinent to ED providers are described for each of three diagnoses: stroke, SAH, and migraine. Recommended future research also includes investigation of the biologic and pathophysiologic differences between men and women with neurologic emergencies as they pertain to ED diagnoses and treatments.
脑血管神经急症,包括缺血性和出血性中风、蛛网膜下腔出血(SAH)以及偏头痛,是导致死亡和残疾的主要原因,常在急诊科(ED)进行诊断和治疗。尽管神经急症中的性别差异开始变得更加清晰,但关于急诊医生应如何将性别因素纳入其研究计划、患者评估以及这些病症的整体管理计划,仍有许多问题尚未得到解答。在评估了现有文献中的差距后,一组核心的急诊科研究人员制定了未来研究重点的草案。2014年学术急诊医学共识会议神经急症工作组的参与者随后使用标准化的名义小组技术讨论并批准了推荐的研究议程。针对中风、SAH和偏头痛这三种诊断中的每一种,都描述了关于性别在与急诊科医护人员相关的诊断、治疗和结果中的作用的未来研究建议。推荐的未来研究还包括调查患有神经急症的男性和女性在与急诊科诊断和治疗相关方面的生物学和病理生理学差异。