Hotta Kazuko, Sorimachi Takatoshi, Honda Yumie, Matsumae Mitsunori
Department of Neurosurgery, Tokai University, Kanagawa, Japan.
Department of Neurosurgery, Tokai University, Kanagawa, Japan.
World Neurosurg. 2017 Sep;105:47-52. doi: 10.1016/j.wneu.2017.05.105. Epub 2017 May 27.
Sex differences in various diseases recently have been recognized as an important factor in the approach to more efficient preventive and therapeutic medicine. We clarified sex differences in the clinical characteristics of chronic subdural hematoma (CSDH) by comparing men and women with CSDH, as there is a well-known male predominance in the prevalence of CSDH.
Clinical factors and computed tomography findings were investigated retrospectively in 490 consecutive patients admitted to our hospital between 2006 and 2015 who were diagnosed with CSDH.
On univariate analysis, women were significantly older than men (P < 0.05). In women, premorbid impaired activities of daily living, consciousness disturbance, acute-to-chronic subdural hematoma, and death as outcomes at discharge were significantly more frequent than in men (P < 0.05). In contrast, women had less frequent instances of good recovery and less alcohol intake (P < 0.05). Multivariate analysis demonstrated female sex as an independent predictor of consciousness disturbance at admission. Female sex also was identified as a predictor of death at discharge.
We demonstrated sex differences in the clinical characteristics of CSDH. In the future, management of patients with CSDH with regard to sex differences in disease characteristics could be expected to improve the outcomes of women, which have been worse than in men.
各种疾病中的性别差异最近已被认为是实现更有效预防和治疗医学的一个重要因素。由于慢性硬膜下血肿(CSDH)的患病率男性明显高于女性,我们通过比较男性和女性CSDH患者,阐明了CSDH临床特征中的性别差异。
对2006年至2015年间连续入住我院并被诊断为CSDH的490例患者的临床因素和计算机断层扫描结果进行回顾性研究。
单因素分析显示,女性患者的年龄显著大于男性(P<0.05)。女性患者病前日常生活活动受损、意识障碍、急性至慢性硬膜下血肿以及出院时死亡的发生率显著高于男性(P<0.05)。相比之下,女性患者恢复良好的情况较少,饮酒量也较少(P<0.05)。多因素分析表明,女性是入院时意识障碍的独立预测因素。女性也是出院时死亡的预测因素。
我们证明了CSDH临床特征中的性别差异。未来,考虑到疾病特征的性别差异对CSDH患者进行管理,有望改善女性患者的治疗结果,目前女性患者的治疗结果比男性差。