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机械通气 ICU 患者结局的性别和年龄差异:一项中国多中心回顾性研究。

Gender- and age-based differences in outcomes of mechanically ventilated ICU patients: a Chinese multicentre retrospective study.

机构信息

Department of Critical Care Medicine, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, 100144, China.

Department of Critical Care Medicine, Fu Xing Hospital, Capital Medical University, No.20 Fuxingmenwai Street, Xicheng District, Beijing, 100038, China.

出版信息

BMC Anesthesiol. 2022 Jan 10;22(1):18. doi: 10.1186/s12871-021-01555-8.

Abstract

BACKGROUND

Previous studies have suggested that the gender and/or age of a patient may influence the clinical outcomes of critically ill patients. Our aim was to determine whether there are gender- and age-based differences in clinical outcomes for mechanically ventilated patients in intensive care units (ICUs).

METHODS

We performed a multicentre retrospective study involving adult patients who were admitted to the ICU and received at least 24 h of mechanical ventilation (MV). The patients were divided into two groups based on gender and, subsequently, further grouped based on gender and age < or ≥ 65 years. The primary outcome measure was hospital mortality.

RESULTS

A total of 853 mechanically ventilated patients were evaluated. Of these patients, 63.2% were men and 61.5% were ≥ 65 years of age. The hospital mortality rate for men was significantly higher than that for women in the overall study population (P = 0.042), and this difference was most pronounced among elderly patients (age ≥ 65 years; P = 0.006). The durations of MV, ICU lengths of stay (LOS), and hospital LOS were significantly longer for men than for women among younger patients (P ≤ 0.013) but not among elderly patients. Multivariate logistic regression analysis revealed that male gender was independently associated with hospital mortality among elderly patients but not among younger patients.

CONCLUSIONS

There were important gender- and age-based differences in the outcomes among mechanically ventilated ICU patients. The combination of male gender and advanced age is strongly associated with hospital mortality.

摘要

背景

之前的研究表明,患者的性别和/或年龄可能会影响危重症患者的临床结局。我们的目的是确定在重症监护病房(ICU)接受机械通气的患者的临床结局是否存在基于性别和年龄的差异。

方法

我们进行了一项多中心回顾性研究,纳入了入住 ICU 并接受至少 24 小时机械通气(MV)的成年患者。根据性别将患者分为两组,随后根据性别和年龄<65 岁或≥65 岁进一步分组。主要结局测量指标为医院死亡率。

结果

共评估了 853 例接受机械通气的患者。其中,63.2%为男性,61.5%为≥65 岁。在总体研究人群中,男性的医院死亡率明显高于女性(P=0.042),这一差异在老年患者中更为明显(年龄≥65 岁;P=0.006)。在年轻患者中,男性 MV 持续时间、ICU 住院时间(LOS)和医院 LOS 明显长于女性(P≤0.013),但在老年患者中并非如此。多变量逻辑回归分析显示,男性性别与老年患者的医院死亡率独立相关,但与年轻患者无关。

结论

在接受机械通气的 ICU 患者中,存在重要的基于性别和年龄的结局差异。男性性别和高龄的组合与医院死亡率密切相关。

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