Department of Neurosurgery, Fengtai District, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring West Road, Beijing, 100070, China.
Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Neurosurg Rev. 2022 Oct;45(5):3339-3347. doi: 10.1007/s10143-022-01836-x. Epub 2022 Jul 23.
Aneurysmal subarachnoid hemorrhage (aSAH) is the most devastating form of stroke. Up to now, little is known about the effect of sex differences on complications and outcomes. We retrospectively reviewed aSAH patients admitted to our institution between January 2015 and December 2020. The functional outcomes at discharge and 90 days after discharge were assessed using the modified Rankin Scale (mRS). Baseline characteristics, in-hospital complications, and outcomes were compared after 1:1 propensity score matching (PSM). The area under the curve (AUC) in the receiver operating characteristic curve (ROC) analysis was calculated to measure each independent risk factor's prediction ability. A total of 833 patients were included. After PSM, 109 male patients were compared with 109 female patients. Female patients had a higher incidence of anemia (47/109 [43.1%] vs. 30/109 [27.5%], p = 0.016) than male patients, while male patients had a higher incidence of pneumonia (36/109 [33.0%] vs. 19/109 [17.4%], p = 0.008) than female patients. No significant differences were found in the rate of unfavorable outcomes at discharge and 90-day outcomes (40/109 [36.7%] vs. 50/109 [45.9%], p = 0.169; 15/109 [13.8%] vs. 19/107 [17.8%], p = 0.420) between female and male patients. Pneumonia (AUC = 0.749, 95% confidence interval [CI] = 0.623-0.875, p < 0.001) and anemia (AUC = 0.753, 95% CI = 0.632-0.873, p = 0.002) showed good ability to predict 90-day unfavorable outcomes in male and female patients, respectively. Female patients had a higher incidence of anemia but a lower incidence of pneumonia during hospitalization. However, differences in in-hospital complications did not result in differences in outcomes between women and men. Clinical Trial Registration: NCT04785976. 2021/03/05, retrospectively registered.
颅内动脉瘤性蛛网膜下腔出血（aSAH）是最具破坏性的中风类型。到目前为止，人们对性别差异对并发症和结局的影响知之甚少。我们回顾性分析了 2015 年 1 月至 2020 年 12 月期间在我院住院的 aSAH 患者。出院时和出院后 90 天使用改良 Rankin 量表（mRS）评估功能结局。通过 1:1 倾向评分匹配（PSM）比较基线特征、住院期间并发症和结局。计算受试者工作特征曲线（ROC）分析中曲线下面积（AUC）以衡量每个独立风险因素的预测能力。共纳入 833 例患者。PSM 后，109 例男性患者与 109 例女性患者进行比较。与男性患者（47/109 [43.1%]）相比，女性患者贫血发生率更高（47/109 [43.1%] vs. 30/109 [27.5%]，p=0.016），而男性患者肺炎发生率更高（36/109 [33.0%] vs. 19/109 [17.4%]，p=0.008）。与女性患者相比，男性患者出院时和 90 天结局的不良结局发生率无显著差异（40/109 [36.7%] vs. 50/109 [45.9%]，p=0.169；15/109 [13.8%] vs. 19/107 [17.8%]，p=0.420）。肺炎（AUC=0.749，95%置信区间[CI] 0.623-0.875，p<0.001）和贫血（AUC=0.753，95% CI 0.632-0.873，p=0.002）在男性和女性患者中均具有良好的预测 90 天不良结局的能力。住院期间，女性患者贫血发生率较高，肺炎发生率较低。然而，女性和男性之间的住院并发症差异并未导致结局差异。临床试验注册：NCT04785976. 2021/03/05，回顾性注册。
