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静脉血栓栓塞症结局的性别差异:基于全国住院患者样本(NIS)的分析。

Sex-based disparities in venous thromboembolism outcomes: A National Inpatient Sample (NIS)-based analysis.

作者信息

Marshall Ariela L, Bartley Adam C, Ashrani Aneel A, Pruthi Rajiv K, Durani Urshila, Gonsalves Wilson I, Kapoor Prashant, Hashmi Shahrukh K, Siddiqui Mustaqeem A, Go Ronald S

机构信息

1 Division of Hematology, Mayo Clinic, Rochester, MN, USA.

2 Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA.

出版信息

Vasc Med. 2017 Apr;22(2):121-127. doi: 10.1177/1358863X17693103. Epub 2017 Mar 20.

Abstract

Venous thromboembolism (VTE) contributes to significant morbidity, mortality, and socioeconomic burden. There is a paucity of literature regarding sex-based sociodemographic differences in VTE presentation and short-term outcomes. We aimed to compare clinical outcomes between men and women hospitalized for VTE management. We performed a retrospective analysis using data from the National Inpatient Sample (NIS) database from 2012 to 2013. Inclusion criteria were age 18 years and older and a primary discharge diagnosis of VTE. Sociodemographic features and medical comorbidities were analyzed, as were hospital length of stay and in-hospital mortality rates. A total of 107,896 patients met the inclusion criteria; 53% were female. Median age was 65 years (interquartile range 51-77) and women were older than men (65 vs 62 years, p<0.001). There were significant differences between men and women with respect to race, primary insurance payer and medical comorbidities, and small differences with respect to VTE location. Female sex was associated with a small but significantly longer hospital length of stay (mean ratio 1.04, 95% CI 1.03-1.05, p<0.001) but no significant difference in in-hospital mortality (2.2% vs 2.1%, p=0.15). In a multivariate model, there was no significant difference between women and men with respect to hospital length of stay or in-hospital mortality. In conclusion, we used data from the NIS to study over 100,000 patients hospitalized for VTE, and identified several sex-based disparities in sociodemographic factors and location of VTE. However, in a multivariable analysis correcting for these factors, sex was not associated with significant differences in clinical outcomes.

摘要

静脉血栓栓塞症(VTE)会导致严重的发病、死亡及社会经济负担。关于VTE临床表现及短期预后的性别社会人口学差异的文献较少。我们旨在比较因VTE治疗而住院的男性和女性的临床结局。我们使用2012年至2013年国家住院患者样本(NIS)数据库的数据进行了一项回顾性分析。纳入标准为年龄18岁及以上且主要出院诊断为VTE。分析了社会人口学特征和医疗合并症,以及住院时间和院内死亡率。共有107,896名患者符合纳入标准;其中53%为女性。中位年龄为65岁(四分位间距51 - 77岁),女性比男性年龄大(65岁对62岁,p<0.001)。男性和女性在种族、主要保险支付方和医疗合并症方面存在显著差异,在VTE部位方面存在微小差异。女性与稍长但显著更长的住院时间相关(平均比值1.04,95%置信区间1.03 - 1.05,p<0.001),但院内死亡率无显著差异(2.2%对2.1%,p = 0.15)。在多变量模型中,女性和男性在住院时间或院内死亡率方面无显著差异。总之,我们使用NIS的数据研究了超过100,000名因VTE住院的患者,并确定了社会人口学因素和VTE部位方面的几个基于性别的差异。然而,在对这些因素进行校正的多变量分析中,性别与临床结局的显著差异无关。

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