Zhou Yang, Peng Wen, Yang Guifang, Pan Xiaogao, Ding Ning, Zhang Hongliang, Peng Zhenyu, Zhang Dongshan, Wu Sijie, Chai Xiangping
Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.
Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, People's Republic of China.
Risk Manag Healthc Policy. 2021 Jan 27;14:323-330. doi: 10.2147/RMHP.S289943. eCollection 2021.
The management of acute aortic dissection (AAD) has improved; however, the outcomes related to different gender with short-term outcomes in non-surgically managed AAD with hypertension are still limited. Our objective was to explore gender-differences in association with short-term outcomes of patients comorbid with hypertension in non-surgically managed AAD.
This is an observational retrospective single-center cohort. We analyzed the data from the Second Xiangya Hospital of Central South University (2014-2018). The data on demographics, clinical presentation, chronic comorbidities, laboratory testing, imaging studies, and treatment were analyzed for all patients. Univariate and multiple analyses were used to test gender-difference associated with short-term outcomes of patients with hypertension in non-surgically managed AAD.
In total, 288 patients were enrolled in this study, of whom 238 (82.63%) were male and 50 (17.37%) were females. About 74% of female patients were dead in-hospital, which was more than male patients (56.3%). Female patients with diabetes mellitus were more than male patients (14% vs 2.94%), while male patients with smoking were significant higher than female patients (36.55% vs 8%). In the full model (model 3), after adjusting for confounding variables, the female AAD patients were more likely to have worse short-term outcomes (OR=3.60, 95% CI=1.41 to 9.60).
Female patients were more likely to have worse outcomes in non-surgically managed AAD patients with hypertension. Large numbers of investigations are required to further explore this relationship.
急性主动脉夹层（AAD）的治疗已有改善；然而，在非手术治疗的合并高血压的AAD患者中，不同性别与短期预后相关的研究结果仍然有限。我们的目的是探讨非手术治疗的合并高血压的AAD患者的性别差异与短期预后的关系。
这是一项观察性回顾性单中心队列研究。我们分析了中南大学湘雅二医院（2014 - 2018年）的数据。对所有患者的人口统计学、临床表现、慢性合并症、实验室检查、影像学检查和治疗数据进行了分析。采用单因素和多因素分析来检验非手术治疗的合并高血压的AAD患者的性别差异与短期预后的关系。
本研究共纳入288例患者，其中男性238例（82.63%），女性50例（17.37%）。约74%的女性患者在住院期间死亡，高于男性患者（56.3%）。患有糖尿病的女性患者多于男性患者（14%对2.94%），而吸烟的男性患者显著高于女性患者（36.55%对8%）。在全模型（模型3）中，调整混杂变量后，女性AAD患者更有可能有更差的短期预后（OR = 3.60，95%CI = 1.41至9.60）。
在非手术治疗的合并高血压的AAD患者中，女性患者更有可能有更差的预后。需要大量研究进一步探索这种关系。
