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性别差异对神经内分泌肿瘤患者住院期间的影响。

Impact of sex differences on patients with neuroendocrine neoplasms during hospital admission.

作者信息

Tan Wan Ying, Cramer Laura D, Vijayvergia Namrata, Lustberg Maryam, Kunz Pamela L

机构信息

Department of Hematology and Oncology, University of Connecticut School of Medicine, Farmington, CT, USA.

Surgical Oncology Research Laboratories, Department of Surgery, Yale School of Medicine, New Haven, CT, USA.

出版信息

Ther Adv Med Oncol. 2024 Dec 15;16:17588359241292271. doi: 10.1177/17588359241292271. eCollection 2024.

Abstract

BACKGROUND

Sex disparities are known modifiers of health and disease. In neuroendocrine neoplasms (NENs), sex-based differences have been observed in the epidemiology and treatment-related side effects.

OBJECTIVES

To examine sex differences in demographics, diagnoses present during hospital admission, comorbidities, and outcomes of hospital course among hospitalized patients with NENs.

DESIGN

Retrospective analysis.

METHODS

A descriptive analysis of sex differences was performed on patients with NENs discharged from U.S. community hospitals in 2019 from the National Inpatient Sample (NIS), Healthcare Cost and Utilization Project, and Agency for Healthcare Research and Quality.

RESULTS

A total of 7334 patients with NENs were identified; 4284 patients had primary NENs, and 3050 patients had metastatic NENs. In total, 48.7% were males and 51.3% were females. Distributions of race and ethnicity, and payer types differed by sex ( < 0.001 and  = 0.027, respectively). For race and ethnicity, there were more females in White, Black, and Native American races, and Hispanic ethnicity. For payer types, female predominance was seen with Medicare, Medicaid, private insurance, and self-pay groups. Sex differences were seen in diagnosis made during hospital stay. In all NENs, oral ( = 0.036) and neurologic ( < 0.001) diagnoses were more common in females; ascites ( = 0.002), dysphagia ( = 0.002), biliary ductal obstruction ( = 0.014), and jaundice ( = 0.048) were more common in males. In primary NENs, ascites ( < 0.001) was male predominant. In metastatic NENs, dysphagia ( = 0.003) and jaundice ( = 0.034) were male predominant, whereas females had more headaches ( < 0.001). Nausea and vomiting were female predominant in all NENs ( < 0.001), primary ( = 0.044), and metastatic ( < 0.001) NENs. For comorbidities, arthropathies ( < 0.001), depression ( < 0.001), hypothyroidism ( < 0.001), other thyroid disorders ( < 0.001), chronic pulmonary disease ( = 0.002), and obesity ( < 0.001) were female predominant.

CONCLUSION

There were sex differences in the race and ethnicity, payer types, diagnoses present during hospital admission, and comorbidities among the 2019 NIS hospital discharge sample of patients with NENs.

摘要

背景

性别差异是已知的健康和疾病调节因素。在神经内分泌肿瘤(NENs)中,已观察到在流行病学和治疗相关副作用方面存在基于性别的差异。

目的

研究住院的NENs患者在人口统计学、入院时的诊断、合并症以及住院病程结局方面的性别差异。

设计

回顾性分析。

方法

对2019年从美国国家住院样本(NIS)、医疗成本和利用项目以及医疗保健研究与质量局出院的社区医院NENs患者进行性别差异的描述性分析。

结果

共识别出7334例NENs患者;4284例为原发性NENs,3050例为转移性NENs。总体而言,48.7%为男性,51.3%为女性。种族和民族分布以及支付者类型因性别而异(分别为<0.001和=0.027)。在种族和民族方面,白人、黑人、美洲原住民种族以及西班牙裔民族中女性较多。在支付者类型方面,医疗保险、医疗补助、私人保险和自费群体中女性占主导。住院期间的诊断存在性别差异。在所有NENs中,口腔(=0.036)和神经系统(<0.001)诊断在女性中更常见;腹水(=0.002)、吞咽困难(=0.002)、胆管梗阻(=0.014)和黄疸(=0.048)在男性中更常见。在原发性NENs中,腹水(<0.001)以男性为主。在转移性NENs中,吞咽困难(=0.003)和黄疸(=0.034)以男性为主,而女性头痛更多见(<0.001)。恶心和呕吐在所有NENs(<0.001)、原发性(=0.044)和转移性(<0.001)NENs中以女性为主。关于合并症,关节病(<0.001)、抑郁症(<0.001)、甲状腺功能减退(<0.001)、其他甲状腺疾病(<0.001)、慢性肺病(=0.002)和肥胖(<0.001)以女性为主。

结论

在2019年NIS医院出院的NENs患者样本中,种族和民族、支付者类型、入院时的诊断以及合并症方面存在性别差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f38/11648047/1b6f067c055d/10.1177_17588359241292271-fig1.jpg

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