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三级医院急性心脏监护病房收治患者的心源性休克临床表现、管理及院内结局:性别起作用吗?

Cardiogenic Shock Clinical Presentation, Management, and In-Hospital Outcomes in Patients Admitted to the Acute Cardiac Care Unit of a Tertiary Hospital: Does Gender Play a Role?

作者信息

Jerónimo Adrian, Ferrández-Escarabajal Marcos, Ferrera Carlos, Noriega Francisco J, Diz-Díaz Jesús, Fernández-Jiménez Rodrigo, McInerney Angela, Fernández-Ortiz Antonio, Viana-Tejedor Ana

机构信息

Acute Cardiac Care Unit, Hospital Clínico San Carlos, 28040 Madrid, Spain.

Centro Nacional de Investigación Cardiovascular (CNIC), 28029 Madrid, Spain.

出版信息

J Clin Med. 2020 Sep 27;9(10):3117. doi: 10.3390/jcm9103117.

DOI:10.3390/jcm9103117
PMID:32992550
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7601399/
Abstract

Cardiogenic shock (CS), as the most severe form of heart failure, is associated with very high mortality rates despite therapeutic advances in the last decades. Gender differences in outcomes have been widely reported regarding several cardiovascular diseases. The aim of our study was to evaluate potential gender disparities in clinical presentation, management, and in-hospital outcomes of all ( = 138) patients admitted to the Acute Cardiac Care Unit of a tertiary hospital from 2013 to 2019. Information on demographic characteristics, past medical history, haemodynamic and clinical status at admission, therapeutic management, and in-hospital outcomes was retrospectively collected. Women represented 31.88% of the cohort, were significantly older than the men and had a lower proportion of smokers, chronic obstructive pulmonary disease, and previous acute myocardial infarction (AMI). Most CSs in both groups were AMI-related. Left ventricular ejection fraction at admission was higher in women, who were less likely to receive vasopressors. No differences were observed regarding mechanical circulatory support use and in-patient outcomes, with age being the only factor associated with in-hospital mortality on multivariate analysis.

摘要

心源性休克(CS)作为心力衰竭最严重的形式,尽管在过去几十年治疗上取得了进展,但死亡率仍然很高。关于几种心血管疾病,结局中的性别差异已有广泛报道。我们研究的目的是评估2013年至2019年入住一家三级医院急性心脏监护病房的所有(n = 138)患者在临床表现、管理及住院结局方面潜在的性别差异。回顾性收集了人口统计学特征、既往病史、入院时的血流动力学和临床状况、治疗管理及住院结局等信息。女性占队列的31.88%,年龄显著大于男性,吸烟者、慢性阻塞性肺疾病患者及既往有急性心肌梗死(AMI)的患者比例较低。两组中大多数心源性休克都与急性心肌梗死相关。女性入院时左心室射血分数较高,使用血管升压药的可能性较小。在机械循环支持的使用和住院结局方面未观察到差异,在多变量分析中,年龄是与住院死亡率相关的唯一因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45af/7601399/b9355b6bcb65/jcm-09-03117-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45af/7601399/f179f3378e6b/jcm-09-03117-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45af/7601399/b9355b6bcb65/jcm-09-03117-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45af/7601399/f179f3378e6b/jcm-09-03117-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45af/7601399/b9355b6bcb65/jcm-09-03117-g002.jpg

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Clinical picture, management and risk stratification in patients with cardiogenic shock: does gender matter?心原性休克患者的临床特征、处理和危险分层:性别有影响吗?
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