心房颤动患者住院及医疗服务利用方面的性别差异。

Sex differences in hospitalisation and healthcare utilisation for patients with atrial fibrillation .

作者信息

Middeldorp Melissa E, van Deutekom Colinda, Weil Liann I, Van Gelder Isabelle C, De Ruijter Ursula W, Jeurissen Patrick T, Benjamin Emelia J, van Munster Barbara C, Rienstra Michiel

机构信息

Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.

University of Groningen, University Medical Center Groningen, Department of Geriatric Medicine, Groningen, the Netherlands.

出版信息

Int J Cardiol Heart Vasc. 2025 Jul 12;60:101748. doi: 10.1016/j.ijcha.2025.101748. eCollection 2025 Oct.

DOI:10.1016/j.ijcha.2025.101748

PMID:40852474

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12369424/

Abstract

BACKGROUND

There is limited data on sex differences in healthcare utilization among patients with atrial fibrillation (AF). This study aimed to assess the association of sex and age on healthcare utilization in AF patients.

METHODS

We conducted a retrospective analysis of electronic health records from three hospitals in the Netherlands, including all patients ≥ 18 years with at least one healthcare encounter (outpatient, emergency visit, or inpatient stay). AF diagnoses were identified using ICD-10 codes linked with the Dutch Hospital Data Clinical Classification Software.

RESULTS

Of 226,991 patients, 5127 (2.3 %) had AF (44 % females, mean age 68 ± 12 years). There were no sex differences in outpatient, emergency, or inpatient visits overall. However, females aged 18-59 had more outpatient visits compared to males (6.1 ± 7.9 vs 4.8 ± 5.2, p = 0.001). In contrast, females aged ≥ 75 had fewer outpatient visits (7.2 vs 8.4, p < 0.001) and inpatient days (4.8 vs 5.8, p = 0.027) compared to males. After multivariable adjustment, both sexes aged ≥ 75 had increased risks of inpatient stays (Females: OR 2.53, 95 % CI 2.30-2.78; Males: OR 1.49, 95 % CI 1.46-1.62) and emergency visits (Females: OR 2.14, 95 % CI 1.94-2.35; Males: OR 1.13, 95 % CI 1.03-1.24). Significant interactions between sex and age were found, with females having higher odds of inpatient days (OR 1.99, p < 0.001) and emergency visits (OR 1.23, p < 0.001) compared to males.

CONCLUSION

While no overall sex differences in healthcare utilization were found, significant age-related differences were observed, with females having higher hospital utilization rates, particularly for inpatient stays and emergency visits.

摘要

背景

关于心房颤动（AF）患者医疗服务利用方面的性别差异数据有限。本研究旨在评估性别和年龄与AF患者医疗服务利用之间的关联。

方法

我们对荷兰三家医院的电子健康记录进行了回顾性分析，纳入所有年龄≥18岁且至少有一次医疗接触（门诊、急诊或住院）的患者。使用与荷兰医院数据临床分类软件相关联的ICD - 10编码来识别AF诊断。

结果

在226,991名患者中，5127名（2.3%）患有AF（女性占44%，平均年龄68±12岁）。总体而言，门诊、急诊或住院就诊方面没有性别差异。然而，18 - 59岁的女性门诊就诊次数比男性多（6.1±7.9次 vs 4.8±5.2次，p = 0.001）。相比之下，75岁及以上的女性门诊就诊次数（7.2次 vs 8.4次，p < 0.001）和住院天数（4.8天 vs 5.8天，p = 0.027）比男性少。多变量调整后，75岁及以上的男女住院风险均增加（女性：OR 2.53，95%CI 2.30 - 2.78；男性：OR 1.49，95%CI 1.46 - 1.62）以及急诊就诊风险增加（女性：OR 2.14，95%CI 1.94 - 2.35；男性：OR 1.13，95%CI 1.03 - 1.24）。发现性别和年龄之间存在显著交互作用，女性住院天数（OR 1.99，p < 0.001）和急诊就诊次数（OR 1.23，p < 0.001）的几率高于男性。