Palacios-Fernandez Sergio, Salcedo Mario, Belinchon-Romero Isabel, Gonzalez-Alcaide Gregorio, Ramos-Rincón José-Manuel
Department of Internal Medicine, San Pedro Hospital, 26006 Logroño, Spain.
Department of Clinical Medicine, Miguel Hernandez University, 03550 Alicante, Spain.
J Clin Med. 2022 Sep 23;11(19):5588. doi: 10.3390/jcm11195588.
(1) Background: The aging population poses challenges for hospital systems. Aortic stenosis is among the most frequent diseases in very old patients. The aim of this study was to describe gender and age differences in the clinical characteristics of very old patients hospitalized with aortic stenosis (AoS) in Spain from 2016 to 2019. (2): Methods: A retrospective observational study analyzing data from the national surveillance system for hospital data. Variables analyzed were age group, sex, length of stay, deaths, and comorbidity. (3) Results: The analysis included 46,967 discharges. Altogether, 7.6% of the admissions ended in death. The main reason for admission was heart failure (34.3%), and this increased with age (80−84 years: 26% versus 95−99 years: 56.6%; p < 0.001). The main treatment procedure was the transcatheter aortic valve replacement (12.7%), performed in 14.3% of patients aged 80−84 versus 0.5% in patients aged 95−99 (p < 0.001). In the multivariable analysis, women were admitted with more comorbidities (odds ratio [OR] 1.22, 95% confidence interval [CI] 1.06−1.20). Mortality was similar, albeit women were admitted less for syncope (OR 0.83, 95% CI 0.74−0.93). Women also underwent fewer coronary catheterizations (OR 0.81, 95% CI 0.77−0.87) and echocardiograms (OR 0.96, 95% CI 0.94−0.98). (4) Conclusions: Aortic stenosis leads to a high number of hospital admissions. Women with AoS presented more heart failure and less cardiovascular pathology than men. Also, women are admitted with fewer episodes of syncope and have fewer ultrasounds and catheterizations.
(1) 背景：人口老龄化给医院系统带来了挑战。主动脉瓣狭窄是高龄患者中最常见的疾病之一。本研究的目的是描述2016年至2019年在西班牙因主动脉瓣狭窄（AoS）住院的高龄患者临床特征的性别和年龄差异。(2) 方法：一项回顾性观察研究，分析来自国家医院数据监测系统的数据。分析的变量包括年龄组、性别、住院时间、死亡情况和合并症。(3) 结果：分析包括46967例出院病例。总共有7.6%的入院患者最终死亡。入院的主要原因是心力衰竭（34.3%），且随年龄增加而增加（80 - 84岁：26% 对比 95 - 99岁：56.6%；p < 0.001）。主要治疗方法是经导管主动脉瓣置换术（12.7%），在80 - 84岁患者中的实施率为14.3%，而在95 - 99岁患者中为0.5%（p < 0.001）。在多变量分析中，女性合并症更多（比值比[OR] 1.22，95%置信区间[CI] 1.06 - 1.20）。死亡率相似，不过女性因晕厥入院的比例较低（OR 0.83，95% CI 0.74 - 0.93）。女性接受冠状动脉导管插入术（OR 0.81，95% CI 0.77 - 0.87）和超声心动图检查（OR 0.96，95% CI 0.94 - 0.98）的次数也较少。(4) 结论：主动脉瓣狭窄导致大量住院病例。患有主动脉瓣狭窄的女性比男性出现更多心力衰竭且心血管病变更少。此外，女性因晕厥入院的次数较少，接受超声检查和导管插入术的次数也较少。
