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操作者与患者性别不一致及经皮冠状动脉介入治疗的围手术期结局(来自波兰国家ORPKI注册研究)

Operator-patient sex discordance and periprocedural outcomes of percutaneous coronary intervention (from the ORPKI Polish National Registry).

作者信息

Dziewierz Artur, Vogel Birgit, Zdzierak Barbara, Kuleta Martyna, Malinowski Krzysztof P, Rakowski Tomasz, Piotrowska Aleksandra, Mehran Roxana, Siudak Zbigniew

机构信息

2 Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland.

Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland.

出版信息

Postepy Kardiol Interwencyjnej. 2023 Jun;19(2):113-118. doi: 10.5114/aic.2023.129208. Epub 2023 Jun 30.

Abstract

INTRODUCTION

A recent study suggested that sex discordance between surgeons and patients negatively affects the outcomes of patients undergoing common surgical procedures.

AIM

We sought to assess whether such an impact exists for periprocedural outcomes of percutaneous coronary intervention (PCI).

MATERIAL AND METHODS

From 2014 to 2020, data on 581,744 patients undergoing single-stage coronary angiography and PCI from 154 centers were collected. Patients were divided into four groups based on the patient and operator sex. Operator-patient sex discordance was defined as the procedure done by a male operator on a female patient or by a female operator on a male patient.

RESULTS

Of 581,744 patients treated by 34 female and 782 male operators, 194,691 patients were sex discordant with their operator (female operator with male patient 12,479; male operator with female patient 182,212) while 387,053 were sex concordant (female operator with female patient 6,068; male operator with male patient 380,985). Among female patients, no difference in the risk of periprocedural complications, including death (0.65% vs. 0.82%; = 0.10), between patients discordant versus concordant with operators was observed. Among male patients the risk of death (0.55% vs. 0.43%; = 0.037) and bleeding at the puncture site (0.13% vs. 0.08%; = 0.046) was higher in patients discordant with operators. However, the differences were no longer significant after adjustment for covariates.

CONCLUSIONS

No detrimental effect of operator-patient sex discordance on periprocedural outcomes was confirmed in all-comer patients undergoing PCI. Some of the observed differences in outcomes were primarily related to the differences in baseline risk profile.

摘要

引言

最近的一项研究表明,外科医生与患者之间的性别不一致会对接受普通外科手术的患者的治疗结果产生负面影响。

目的

我们试图评估这种影响是否存在于经皮冠状动脉介入治疗(PCI)的围手术期结果中。

材料与方法

收集了2014年至2020年期间154个中心的581744例接受单阶段冠状动脉造影和PCI的患者的数据。根据患者和操作者的性别将患者分为四组。操作者与患者性别不一致定义为男性操作者对女性患者或女性操作者对男性患者进行的手术。

结果

在由34名女性操作者和782名男性操作者治疗的581744例患者中,194691例患者与操作者性别不一致(女性操作者对男性患者12479例;男性操作者对女性患者182212例),而387053例患者性别一致(女性操作者对女性患者6068例;男性操作者对男性患者380985例)。在女性患者中,未观察到与操作者性别不一致和一致的患者在围手术期并发症风险(包括死亡,0.65%对0.82%;P = 0.10)方面存在差异。在男性患者中,与操作者性别不一致的患者死亡风险(0.55%对0.43%;P = 0.037)和穿刺部位出血风险(0.13%对0.08%;P = 0.046)更高。然而,在对协变量进行调整后,差异不再显著。

结论

在接受PCI的所有患者中,未证实操作者与患者性别不一致对围手术期结果有不利影响。观察到的一些结果差异主要与基线风险特征的差异有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78cf/10351079/e5467435415f/PWKI-19-51020-g001.jpg

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