Department of Neurology, General Hospital of Northern Theater Command, NO.83, Wenhua Road, Shenhe District, Shenyang, 110016, Liaoning, China.
BMC Neurol. 2024 May 4;24(1):153. doi: 10.1186/s12883-024-03659-3.
Sex differences in outcomes of patients with aneurysmal subarachnoid hemorrhage (aSAH) remain controversial. Therefore, the aim of this study was to investigate the sex differences in the prognosis of patients with aSAH.
This study retrospectively analyzed the clinical data of aSAH patients admitted to the Department of Neurosurgery of General Hospital of Northern Theater Command, from April 2020 to January 2022. The modified Rankin Scale (mRS) was used to evaluate outcomes at 3-month post-discharge. Baseline characteristics, in-hospital complications and outcomes were compared after 1:1 propensity score matching (PSM).
A total of 665 patients were included and the majority (63.8%) were female. Female patients were significantly older than male patients (59.3 ± 10.9 years vs. 55.1 ± 10.9 years, P < 0.001). After PSM, 141 male and 141 female patients were compared. Comparing postoperative complications and mRS scores, the incidence of delayed cerebral ischemia (DCI) and hydrocephalus and mRS ≥ 2 at 3-month were significantly higher in female patients than in male patients. After adjustment, the analysis of risk factors for unfavorable prognosis at 3-month showed that age, sex, smoking, high Hunt Hess grade, high mFisher score, DCI, and hydrocephalus were independent risk factors.
Female patients with aSAH have a worse prognosis than male patients, and this difference may be because females are more vulnerable to DCI and hydrocephalus.
关于蛛网膜下腔出血（aSAH）患者结局的性别差异仍存在争议。因此，本研究旨在探讨 aSAH 患者预后的性别差异。
本研究回顾性分析了 2020 年 4 月至 2022 年 1 月期间入住北部战区总医院神经外科的 aSAH 患者的临床资料。采用改良 Rankin 量表（mRS）评估出院后 3 个月的结局。对 1:1 倾向评分匹配（PSM）后，比较基线特征、住院期间并发症和结局。
共纳入 665 例患者，其中大多数（63.8%）为女性。女性患者明显比男性患者年龄更大（59.3±10.9 岁比 55.1±10.9 岁，P<0.001）。PSM 后，比较 141 例男性和 141 例女性患者。术后并发症和 mRS 评分比较，女性患者迟发性脑缺血（DCI）和脑积水以及 3 个月 mRS≥2 的发生率明显高于男性患者。调整后，分析 3 个月预后不良的危险因素显示，年龄、性别、吸烟、高 Hunt Hess 分级、高 mFisher 评分、DCI 和脑积水是独立的危险因素。
aSAH 女性患者的预后较男性患者差，这种差异可能是因为女性更容易发生 DCI 和脑积水。
