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目标温度管理治疗院外心脏骤停患者的神经学结局及心脏骤停后护理的性别差异:一项前瞻性、多中心、观察性队列研究的事后分析

Sex Difference on Neurological Outcomes and Post-Cardiac Arrest Care in Out-of-Hospital Cardiac Arrest Patients Treated with Targeted Temperature Management: Post-Hoc Study of a Prospective, Multicenter, Observational Cohort Study.

作者信息

Park Seon Yeong, Oh Sang Hoon, Park Sang Hyun, Oh Jae Hun, Kim Soo Hyun

机构信息

Department of Emergency Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea.

Department of Emergency Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.

出版信息

J Clin Med. 2023 Aug 14;12(16):5297. doi: 10.3390/jcm12165297.

DOI:10.3390/jcm12165297
PMID:37629339
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10455960/
Abstract

Conflicting results regarding sex-based differences in the outcomes of out-of-hospital cardiac arrest (OHCA) patients have been reported. We aimed to evaluate the association between sex and neurological outcome as well as various in-hospital process in OHCA patients treated with targeted temperature management. We retrospectively analyzed a prospective registry data collected between October 2015 and December 2018. To evaluate the effect of sex on patient outcomes, we created various multivariable logistic regression models. When the results were adjusted using resuscitation variables and in-hospital variables, there was no significant difference (OR = 1.22, 95% CI: 0.85-1.74; OR = 1.13, 95 CI: 0.76-1.68, respectively). Regarding the in-hospital course, the daily total SOFA score was similar in both sexes, whereas cardiovascular scores were higher in women on days 2 and 3. The adjusted effect of sex was not associated with the clinician's decision to perform early cardiac interventions, except for those men that had more extracorporeal membrane oxygenation (OR = 2.51, 95% CI: 1.11-5.66). The findings seems that men had more favorable 6-month neurological outcomes. However, after adjusting for confounders, there was no difference between the sexes. The results regarding in-hospital course were similar in men and women.

摘要

关于院外心脏骤停(OHCA)患者预后的性别差异,已有相互矛盾的结果报道。我们旨在评估性别与神经学预后以及接受目标温度管理治疗的OHCA患者的各种院内治疗过程之间的关联。我们回顾性分析了2015年10月至2018年12月期间收集的前瞻性登记数据。为了评估性别对患者预后的影响,我们创建了各种多变量逻辑回归模型。当使用复苏变量和院内变量进行结果调整时,没有显著差异(OR = 1.22,95% CI:0.85 - 1.74;OR = 1.13,95% CI:0.76 - 1.68)。关于院内病程,两性的每日总序贯器官衰竭评估(SOFA)评分相似,而在第2天和第3天,女性的心血管评分更高。除了接受体外膜肺氧合治疗的男性更多(OR = 2.51,95% CI:1.11 - 5.66)外,性别调整后的效应与临床医生进行早期心脏干预的决定无关。研究结果似乎显示男性在6个月时的神经学预后更好。然而,在对混杂因素进行调整后,两性之间没有差异。男性和女性在院内病程方面的结果相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27f8/10455960/597da2ea6d85/jcm-12-05297-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27f8/10455960/92977f78bd9c/jcm-12-05297-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27f8/10455960/597da2ea6d85/jcm-12-05297-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27f8/10455960/92977f78bd9c/jcm-12-05297-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27f8/10455960/597da2ea6d85/jcm-12-05297-g002.jpg

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本文引用的文献

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External validation of the 2020 ERC/ESICM prognostication strategy algorithm after cardiac arrest.
心脏骤停后 2020 ERC/ESICM 预后策略算法的外部验证。
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