Bhandari Ruchi, Tiwari Shabnam, Alexander Talia, Annie Frank H, Kaleem Umar, Irfan Affan, Balla Sudarshan, Wiener R Constance, Cook Chris, Nanjundappa Aravinda, Bates Mark, Thompson Ellen, Smith Gordon S, Feinberg Judith, Fisher Melanie A
Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Robert C Byrd Health Sciences Center North, 64 Medical Center Drive, Morgantown, WV 26506, USA.
Health Education and Research Institute, Charleston Area Medical Center, Charleston, WV 25304, USA.
J Clin Med. 2022 Jun 18;11(12):3514. doi: 10.3390/jcm11123514.
Infectious diseases like infective endocarditis (IE) may manifest or progress differently between sexes. This study sought to identify the differences in demographic and clinical characteristics among male and female patients with IE. Data were obtained from a newly developed registry comprising all adult patients with first IE admission at the four major tertiary cardiovascular centers in West Virginia, USA during 2014−2018. Patient characteristics were compared between males and females using Chi-square test, Fisher’s exact test, and Wilcoxon rank-sum test. A secondary analysis was restricted to IE patients with drug use only. Among 780 unique patients (390 males, 390 females), significantly more women (a) were younger than males (median age 34.9 vs. 41.4, p < 0.001); (b) reported drug use (77.7% vs. 64.1%, p < 0.001); (c) had tricuspid valve endocarditis (46.4% vs. 30.8%, p < 0.001); and (d) were discharged against medical advice (20% vs. 9.5%, p < 0.001). These differences persisted even within the subgroup of patients with drug use-associated IE. In a state with one of the highest incidences of drug use and overdose deaths, the significantly higher incident IE cases in younger women and higher proportion of women leaving treatment against medical advice are striking. Differential characteristics between male and female patients are important to inform strategies for specialized treatment and care.
感染性心内膜炎（IE）等传染病在不同性别之间可能有不同的表现或进展。本研究旨在确定IE男性和女性患者在人口统计学和临床特征方面的差异。数据来自一个新建立的登记系统，该系统涵盖了2014 - 2018年期间在美国西弗吉尼亚州四个主要三级心血管中心首次因IE入院的所有成年患者。使用卡方检验、费舍尔精确检验和威尔科克森秩和检验对男性和女性患者的特征进行比较。二次分析仅限于仅使用药物的IE患者。在780例独特患者（390例男性，390例女性）中，女性（a）明显比男性年轻（中位年龄34.9岁对41.4岁，p < 0.001）；（b）报告使用药物的比例更高（77.7%对64.1%，p < 0.001）；（c）患有三尖瓣心内膜炎的比例更高（46.4%对30.8%，p < 0.001）；以及（d）不听从医嘱出院的比例更高（20%对9.5%，p < 0.001）。即使在与药物使用相关的IE患者亚组中，这些差异仍然存在。在一个药物使用和过量死亡发生率最高的州之一，年轻女性中IE的发病率明显更高，且不听从医嘱离开治疗的女性比例更高，这一点令人瞩目。男性和女性患者的不同特征对于制定专门的治疗和护理策略很重要。
