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女性糖尿病患者缺血性脑卒中再入院风险更高:一项回顾性队列研究。

Females with diabetes have a higher risk of ischemic stroke readmission: a retrospective cohort study.

机构信息

School of Public Health, Ningxia Medical University, Yinchuan, China.

Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, China.

出版信息

BMC Public Health. 2024 Sep 12;24(1):2488. doi: 10.1186/s12889-024-20006-w.

Abstract

BACKGROUND

There are significant sex differences in the incidence of stroke or diabetes mellitus. However, little is known about sex differences in stroke rehospitalization among diabetic patients.

OBJECT

To explore the sex differences in short-term and long-term rehospitalization of ischemic stroke patients with Type 2 diabetes mellitus.

METHODS

A retrospective cohort study was conducted from 2017 to 2021. The rehospitalization events of ischemic stroke patients with diabetes mellitus were identified by the national unified Electronic Health Record. Propensity score matching was applied to adjust for multiple covariates, and LASSO regression was used to screen for independent variables. Cox proportional hazards model was utilized to analyze the different sex in short-term (90 days, 1 year) and long-term (5 years) rehospitalization in ischemic stroke patients with type 2 diabetes mellitus.

RESULT

A total of 10,724 ischemic stroke patients were included in this study, of whom 5,952 (55.5%) were males. After a 1:1 propensity score matching, there were 3,460 males and 2,772 females. After adjusting for confounding factors, female patients with type 2 diabetes had an increased risk of ischemic stroke rehospitalization at 90 days (HR: 1.94, 95%CI: 1.13-3.33, P < 0.05), 1 year (HR: 1.65, 95%CI:1.22-2.23, P = 0.001), and 5 years (HR: 1.58, 95%CI: 1.26-1.97, P < 0.001). However, there was no significant relationship between male patients with type 2 diabetes and the risk of ischemic stroke rehospitalization, either in the short or long term.

CONCLUSION

Females with type 2 diabetes mellitus have a higher risk of ischemic stroke rehospitalization in both the short-term and long-term.

摘要

背景

在中风或糖尿病的发病率方面存在显著的性别差异。然而,对于糖尿病患者中风再住院的性别差异知之甚少。

目的

探讨 2 型糖尿病缺血性脑卒中患者短期和长期再住院的性别差异。

方法

本研究为回顾性队列研究,时间为 2017 年至 2021 年。通过国家统一的电子健康记录识别糖尿病合并缺血性脑卒中患者的再住院事件。采用倾向评分匹配调整多个协变量,并应用 LASSO 回归筛选自变量。采用 Cox 比例风险模型分析 2 型糖尿病缺血性脑卒中患者短期(90 天、1 年)和长期(5 年)再住院的不同性别。

结果

本研究共纳入 10724 例缺血性脑卒中患者,其中 5952 例(55.5%)为男性。经过 1:1 倾向评分匹配后,男性患者 3460 例,女性患者 2772 例。在调整混杂因素后,女性 2 型糖尿病患者发生缺血性脑卒中再住院的风险在 90 天(HR:1.94,95%CI:1.13-3.33,P<0.05)、1 年(HR:1.65,95%CI:1.22-2.23,P=0.001)和 5 年(HR:1.58,95%CI:1.26-1.97,P<0.001)时均增加。然而,男性 2 型糖尿病患者的缺血性脑卒中再住院风险在短期和长期均无显著相关性。

结论

女性 2 型糖尿病患者缺血性脑卒中再住院的风险在短期和长期均较高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43d5/11396089/528496e2e158/12889_2024_20006_Fig1_HTML.jpg

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