De Marchis Gian Marco, Schaad Chris, Fung Christian, Beck Juergen, Gralla Jan, Takala Jukka, Jakob Stephan M
Department of Neurology & Stroke Center, University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland.
Department of Intensive Care Medicine, Inselspital, University of Bern, Switzerland.
Clin Neurol Neurosurg. 2017 Jun;157:82-87. doi: 10.1016/j.clineuro.2017.04.009. Epub 2017 Apr 6.
Aneurysmal subarachnoid hemorrhage (aSAH) is more common in women than in men. Despite its clinical relevance, knowledge about the potential gender differences in the clinical course and outcome of aSAH is sparse - we aimed at elucidating such differences.
Retrospective cohort study including patients ≥18years of age with aSAH admitted to an interdisciplinary intensive-care center at the University Hospital of Bern (Switzerland).
The study included 120 patients with aSAH. Sixty-nine percent of the enrolled patients were women. The women were older than men (mean [standard deviation] age 58±13years vs. 51±12years, P=0.006), and were increasingly overrepresented across increasing age-strata. Global disease severity at admission, measured by the APACHE II score, was higher in women than in men (median score 18 points [IQR 12-26] vs. 14 points [IQR 10-19], P=0.006). Men and women had similar medical histories and severity of aSAH. We found no evidence for major differences in the adopted aneurysm-securing strategy and intensive care interventions. At 6 months from aSAH, mortality was higher in women than men (28% vs. 16%), but this did not reach statistical significance (P=0.25). APACHE II, but not gender, was associated with unfavorable outcome at 6 months.
Women outnumbered men among aSAH patients, especially along increasing age strata, and had increased global disease severity on admission. No other significant differences between genders were found.
动脉瘤性蛛网膜下腔出血（aSAH）在女性中比在男性中更常见。尽管其具有临床相关性，但关于aSAH临床病程和结局中潜在性别差异的知识却很匮乏——我们旨在阐明此类差异。
回顾性队列研究，纳入年龄≥18岁、因aSAH入住瑞士伯尔尼大学医院跨学科重症监护中心的患者。
该研究纳入了120例aSAH患者。登记患者中有69%为女性。女性比男性年龄更大（平均[标准差]年龄58±13岁 vs. 51±12岁，P = 0.006），且在各年龄层中女性的占比越来越高。入院时用急性生理与慢性健康状况评分系统（APACHE II）衡量的整体疾病严重程度，女性高于男性（中位数评分18分[四分位间距12 - 26] vs. 14分[四分位间距10 - 19]，P = 0.006）。男性和女性有相似的病史及aSAH严重程度。我们没有发现采用的动脉瘤固定策略和重症监护干预存在重大差异的证据。aSAH发生6个月时，女性死亡率高于男性（28% vs. 16%），但未达到统计学显著性（P = 0.25）。APACHE II评分而非性别与6个月时的不良结局相关。
aSAH患者中女性人数多于男性，尤其是在年龄增长的各层中，且入院时整体疾病严重程度更高。未发现其他性别间的显著差异。
