Yang Liting, Han Jian, Qin Chenghui, Shou Weiqing
Department of Neurology, Affiliated Hospital of Shaoxing University, Shaoxing, China.
Department of Geriatrics, Affiliated Hospital of Shaoxing University, Shaoxing, China.
Cerebrovasc Dis. 2024;53(6):753-766. doi: 10.1159/000535612. Epub 2023 Dec 7.
The aim of the study was to provide updated evidence on the sex-based differences in the risk of mortality and functional outcomes in subjects with intracerebral haemorrhage.
A systematic search of eligible studies was conducted using three large databases such as PubMed, EMBASE, and Scopus for observational studies that documented the comparative risk of mortality and functional outcomes based on the subjects' sex. Only studies published in the year 2000 and onwards were included. Random-effects model was used to pool relevant data, and effect sizes were reported as odds ratios (ORs) with 95% confidence intervals (CI).
The review included 32 studies. In most of the studies, female subjects had a higher mean age compared to males and had a higher rate of neurological deficits at admission. A higher proportion of males had cardiovascular risk factors. The risk of mortality at hospital discharge (OR 0.98, 95% CI: 0.90, 1.06), 1-month (OR 0.98, 95% CI: 0.81, 1.18), 3-month (OR 1.13, 95% CI: 0.95, 1.33), and 12-month (OR 1.04, 95% CI: 0.90, 1.19) follow-up was similar in both sexes. Compared to females, males had a lower risk of poor functional outcomes at 3-month (OR 0.83, 95% CI: 0.77, 0.89) and 12-month (OR 0.87, 95% CI: 0.77, 0.98) follow-up.
There is a similar risk of mortality but better functional outcomes in males with intracerebral haemorrhage compared to females. However, the findings should be interpreted cautiously as there were significant sex-based differences in risk profiles at admission. Further studies that focus on careful and meticulous examination of sex-specific association with survival and functional outcomes are needed.
本研究的目的是提供关于脑出血患者死亡风险和功能结局的性别差异的最新证据。
使用三个大型数据库（如PubMed、EMBASE和Scopus）对符合条件的研究进行系统检索，以查找记录基于受试者性别的死亡风险和功能结局比较的观察性研究。仅纳入2000年及以后发表的研究。采用随机效应模型汇总相关数据，效应大小以比值比（OR）及其95%置信区间（CI）表示。
该综述纳入了32项研究。在大多数研究中，女性受试者的平均年龄高于男性，入院时神经功能缺损率更高。男性有心血管危险因素的比例更高。出院时（OR 0.98，95% CI：0.90，1.06）、1个月（OR 0.98，95% CI：0.81，1.18）、3个月（OR 1.13，95% CI：0.95，1.33）和12个月（OR 1.04，95% CI：0.90，1.19）随访时的死亡风险在两性中相似。与女性相比，男性在3个月（OR 0.83，95% CI：0.77，0.89）和12个月（OR 0.87，95% CI：0.77，0.98）随访时功能结局不良的风险较低。
脑出血男性患者的死亡风险与女性相似，但功能结局更好。然而，由于入院时风险特征存在显著的性别差异，这些发现应谨慎解读。需要进一步开展研究，仔细且细致地检查性别与生存及功能结局的特定关联。
