Zhao Ning, Pan Zelin, Yang Qilin, Chen Juanmei, Ruan Dongxue, Huang Meiqi, Lu Peilin, Chen Xumin, Huang Xinqiao, Lin Xiaozhen, Mo Pei
Guangzhou Institute of Cardiovascular Disease, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Ann Transl Med. 2022 Dec;10(24):1313. doi: 10.21037/atm-22-5141.
Maintaining tissue perfusion and oxygen supply are essential for cardiogenic shock (CS) treatment. Sex has been reported to be associated with mortality and oxygen use in patients with CS. Males and females respond differently to hypoxia. We designed this cohort study to evaluate the effects of sex on the association between the arterial partial pressure of oxygen (PaO) and in-hospital mortality.
We used the Medical Information Mart for Intensive Care (MIMIC) IV database for this cohort study. The outcome was in-hospital mortality. The relationship between the PaO and in-hospital mortality was compared with sex (via an interaction test) using multivariable Cox regression models. Presence of interaction between PaO and sex was tested by using inter interaction terms.
A total of 1,772 patients with CS were enrolled in this study. The association between PaO and in-hospital mortality appeared to differ between males and females [hazard ratio (HR): 0.997, 95% confidence interval (CI): 0.995-0.999 HR: 1.002, 95% CI: 0.999-1.003, P for interaction =0.002]. We repeated the analyses, based on different PaO category (PaO <60 mmHg; PaO 60-100 mmHg; PaO >100 mmHg) and the results remained stable, P for interaction =0.008.
Sex affects the relationship between PaO and in-hospital mortality in CS patients. Our findings may lead to the development of individualized therapies that focus on the use of different target oxygen partial pressures in different sexes to treat patients with CS.
维持组织灌注和氧气供应是心源性休克（CS）治疗的关键。据报道，性别与CS患者的死亡率和氧气使用情况相关。男性和女性对缺氧的反应不同。我们设计了这项队列研究，以评估性别对动脉血氧分压（PaO）与住院死亡率之间关联的影响。
我们使用重症监护医学信息集市（MIMIC）IV数据库进行这项队列研究。结局指标为住院死亡率。使用多变量Cox回归模型，通过交互作用检验比较PaO与住院死亡率之间的关系以及性别差异。通过使用交互项检验PaO与性别之间是否存在交互作用。
本研究共纳入1772例CS患者。男性和女性中，PaO与住院死亡率之间的关联似乎存在差异[风险比（HR）：0.997，95%置信区间（CI）：0.995 - 0.999；HR：1.002，95%CI：0.999 - 1.003，交互作用P值 = 0.002]。我们基于不同的PaO类别（PaO < 60 mmHg；PaO 60 - 100 mmHg；PaO > 100 mmHg）重复进行分析，结果保持稳定，交互作用P值 = 0.008。
性别影响CS患者中PaO与住院死亡率之间的关系。我们的研究结果可能会促使开发个性化治疗方案，即针对不同性别的患者使用不同的目标氧分压来治疗CS。
