Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo.
Circ J. 2019 Aug 23;83(9):1937-1943. doi: 10.1253/circj.CJ-19-0357. Epub 2019 Jul 27.
The effect of the sex ratio of the team of the attending doctors on clinical outcomes remains unknown.
This retrospective cohort study included 9,544 patients admitted between 2012 and 2018 for cardiovascular diseases. They were treated by teams of 3 attending doctors comprising a trainee doctor, middle-grade cardiologist who played the main role in the clinical management, and upper-grade cardiologist who was responsible for the management. We explored whether the sex of the attending doctors influenced the risk of emergency readmission within 30 days after discharge. The primary hospitalization periods were similar for male and female middle-grade cardiologists. The risk of emergency readmission of patients hospitalized with cardiovascular diseases was significantly higher for patients treated by male middle-grade cardiologists than in those treated by female middle-grade cardiologists (odds ratio: 2.09, P<0.01). This beneficial effect of treatment by female cardiologists was observed in younger (<65 years) patients, male patients, patients with New York Heart Association stages II-IV, and those with emergency primary hospitalization, and in medical teams led by a male upper-grade cardiologist.
The risk of emergency readmission after discharge in patients hospitalized with cardiovascular diseases was ameliorated when treatment was performed by female middle-grade cardiologists. The combination of male and female cardiologists in the attending doctors' team could result in better prognoses for cardiovascular patients.
主治医生团队的性别比例对临床结果的影响尚不清楚。
这是一项回顾性队列研究,纳入了 2012 年至 2018 年间因心血管疾病住院的 9544 名患者。他们由 3 名主治医生组成的团队进行治疗,其中包括一名受训医生、一名中级心脏病专家,他在临床管理中起主要作用,以及一名上级心脏病专家,他负责管理。我们探讨了主治医生的性别是否会影响出院后 30 天内的急诊再入院风险。男性和女性中级心脏病专家的主要住院时间相似。与由女性中级心脏病专家治疗的患者相比,由男性中级心脏病专家治疗的心血管疾病患者的急诊再入院风险显著更高(比值比:2.09,P<0.01)。这种女性心脏病专家治疗的有益效果在年龄较小(<65 岁)的患者、男性患者、纽约心脏协会 II-IV 期的患者以及急诊初诊的患者以及由男性上级心脏病专家领导的医疗团队中观察到。
由女性中级心脏病专家治疗的心血管疾病患者出院后急诊再入院的风险降低。主治医生团队中男女心脏病专家的结合可能会使心血管病患者的预后更好。