Papa Linda, Cienki John J, Wilson Jason W, Axline Virginia, Coyle Emily A, Earwood Ryan C, Thundiyil Josef G, Ladde Jay G
Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida, USA.
Department of Emergency Medicine, Jackson Memorial Hospital, Miami, Florida, USA.
Neurotrauma Rep. 2023 Sep 12;4(1):605-612. doi: 10.1089/neur.2023.0050. eCollection 2023.
Previous studies have suggested that there are sex differences in the treatment and outcome of neurological emergencies; however, research identifying the role these sex differences play in the management of neurological emergencies is lacking. More knowledge of the way sex factors into the pathophysiology of neurological emergencies will be helpful in improving outcomes for these patients. The aim of this cross-sectional study was to assess the prevalence and management of neurological emergencies while evaluating sex differences in the diagnosis and treatment of these emergencies. We analyzed a cohort of 530 adult patients from four level 1 trauma centers over a period of 4 weeks who had a chief complaint of a neurological emergency, including seizures, cerebrovascular events, headache disorders, traumatic brain injuries, and central nervous system infections. Among patients with neurological emergencies, a significantly lower proportion of female patients underwent neurosurgery and were admitted to the intensive care unit compared to male patients, but there were no significant differences between sexes in the time of symptom onset, type of hospital transportation, amount of neuroimaging performed, admission rates, hospital length of stay, and disposition from the emergency department. Although female patients were more likely to have a chief complaint of headache compared to traumatic injuries in male patients, this was not statistically significant. A significantly higher proportion of female patients had health insurance coverage than male patients.
以往的研究表明，神经急症的治疗和预后存在性别差异；然而，目前缺乏关于这些性别差异在神经急症管理中所起作用的研究。更多地了解性别因素在神经急症病理生理学中的作用方式，将有助于改善这些患者的预后。这项横断面研究的目的是评估神经急症的患病率和管理情况，同时评估这些急症诊断和治疗中的性别差异。我们分析了来自四个一级创伤中心的530名成年患者，这些患者在4周内以神经急症为主诉，包括癫痫发作、脑血管事件、头痛疾病、创伤性脑损伤和中枢神经系统感染。在患有神经急症的患者中，与男性患者相比，接受神经外科手术和入住重症监护病房的女性患者比例显著较低，但在症状发作时间、医院转运类型、神经影像学检查量、入院率、住院时间和急诊科处置方面，两性之间没有显著差异。尽管与男性患者因创伤受伤相比，女性患者更有可能以头痛为主诉，但这在统计学上并不显著。女性患者拥有医疗保险的比例显著高于男性患者。
