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J Heart Lung Transplant:机械循环支持治疗女性患者预后较差

2016-10-30 MedSci MedSci原创

背景:机械循环支持(MCS)是一种广泛使用的管理策略。没有研究描述体外和持续MCS的性别差异。研究者应用入院数据分析体外和持续MCS住院预后的性别差异。方法:总的来说,使用国际分类疾病编码-9(临床修正)筛选出1994和2012之间进行MCS,有 1亿3450万的医院记录。主要不良事件(MAE)被定义为死亡、大出血、卒中、装置感染或机械并发症。根据INTERMACS的季度报告,在年度基础上确定IN

背景:机械循环支持(MCS)是一种广泛使用的管理策略。没有研究描述体外和持续MCS的性别差异。研究者应用入院数据分析体外和持续MCS住院预后的性别差异。

方法:总的来说,使用国际分类疾病编码-9(临床修正)筛选出1994和2012之间进行MCS,有 1亿3450万的医院记录。主要不良事件(MAE)被定义为死亡、大出血、卒中、装置感染或机械并发症。根据INTERMACS的季度报告,在年度基础上确定INTERMACS登记。使用多变量逻辑回归确定特征和预后之间的相关性。

结果:3523/4337例接受MCS设备患者有性别记录。这些患者来自45 INTERMACS网点和 (n = 1383)和246(n = 2954)非INTERMACS网点的患者,22%为女性。基线特征与女性年轻(33.5% vs 27.4%,年龄<50岁,P<0.001;平均55.7±17.3 vs 56.1±14.6岁)合并症较少显著相关。女性的住院死亡率(52.3% vs 40.8%,P<0.001)和MAEs(64.8% vs 52.5%,P<0.001)发生率更高。校正多变量的预测因素,女性发生MAEs的可能性为89%(P<0.001)。随着时间的推移,男性和女性的住院死亡率均下降,(相对风险减少10%/年,P<0.001),但在整个研究期间女性死亡率高于男性。

结论:接受MCS的患者,基本特征和预后有性别差异。女性患者有较高的住院死亡率及MAEs的风险升高,这不能以年龄或共发病来解释。需要进一步的研究这不相称的结果。

原始出处:

McIlvennan CK, Lindenfeld J, Kao DP. Sex differences and in-hospital outcomes in patients undergoing mechanical circulatory support implantation. J Heart Lung Transplant. 2016 Aug 20.


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[GetPortalCommentsPageByObjectIdResponse(id=2033501, encodeId=4f47203350173, content=<a href='/topic/show?id=446044648ad' target=_blank style='color:#2F92EE;'>#女性患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44648, encryptionId=446044648ad, topicName=女性患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e0a1165, createdName=jiangfeng5067, createdTime=Tue Nov 08 07:15:00 CST 2016, time=2016-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1921050, encodeId=ea7b1921050c1, content=<a href='/topic/show?id=921b5e08167' target=_blank style='color:#2F92EE;'>#支持治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57081, encryptionId=921b5e08167, topicName=支持治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=640c454, createdName=qblt, createdTime=Sat Feb 25 05:15:00 CST 2017, time=2017-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1957798, encodeId=430b195e7987d, content=<a href='/topic/show?id=277f6124588' target=_blank style='color:#2F92EE;'>#机械循环支持#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61245, encryptionId=277f6124588, topicName=机械循环支持)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/uiafWKNzZJdibyrrAR5YyVBUCbj0fhAekic1Tou5YEI9IBoJ1QrGpZylYAkiafDNofZkNHJCPTpY1HK14LvuFzD5xQ/132, createdBy=706e2500208, createdName=ms9203727104890838, createdTime=Wed Jun 07 19:15:00 CST 2017, time=2017-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1789136, encodeId=9ba61e89136c8, content=<a href='/topic/show?id=0c8814344f5' target=_blank style='color:#2F92EE;'>#plant#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14344, encryptionId=0c8814344f5, topicName=plant)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f5b299, createdName=xuyu, createdTime=Thu Nov 24 01:15:00 CST 2016, time=2016-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1691887, encodeId=b78d169188e8f, content=<a href='/topic/show?id=a450530853c' target=_blank style='color:#2F92EE;'>#患者预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53085, encryptionId=a450530853c, topicName=患者预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f4729287700, createdName=bnurmamat, createdTime=Mon May 29 19:15:00 CST 2017, time=2017-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1656732, encodeId=0a971656e3228, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Sat Jun 10 13:15:00 CST 2017, time=2017-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1796121, encodeId=b6f51e96121a4, content=<a href='/topic/show?id=691c1e765a0' target=_blank style='color:#2F92EE;'>#Transplant#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17765, encryptionId=691c1e765a0, topicName=Transplant)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=232a2500033, createdName=1249859em38(暂无昵称), createdTime=Mon Sep 11 13:15:00 CST 2017, time=2017-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157148, encodeId=e00315e148fc, content=介绍的很详细, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLAN4jREMZucufWSjHRyVSdVFDkx9nZbn3Dybooed1zgZzIEKYicfwKSREcTuRkwP19Q1TLbvZ424s/0, createdBy=1d791982726, createdName=一个知识的乞求者, createdTime=Sun Nov 20 23:34:59 CST 2016, time=2016-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356131, encodeId=06c613561312e, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Nov 01 01:15:00 CST 2016, time=2016-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562400, encodeId=a787156240020, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Nov 01 01:15:00 CST 2016, time=2016-11-01, status=1, ipAttribution=)]
    2016-11-24 xuyu
  5. 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content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Sat Jun 10 13:15:00 CST 2017, time=2017-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1796121, encodeId=b6f51e96121a4, content=<a href='/topic/show?id=691c1e765a0' target=_blank style='color:#2F92EE;'>#Transplant#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17765, encryptionId=691c1e765a0, topicName=Transplant)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=232a2500033, createdName=1249859em38(暂无昵称), createdTime=Mon Sep 11 13:15:00 CST 2017, time=2017-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157148, encodeId=e00315e148fc, content=介绍的很详细, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLAN4jREMZucufWSjHRyVSdVFDkx9nZbn3Dybooed1zgZzIEKYicfwKSREcTuRkwP19Q1TLbvZ424s/0, createdBy=1d791982726, createdName=一个知识的乞求者, createdTime=Sun Nov 20 23:34:59 CST 2016, time=2016-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356131, encodeId=06c613561312e, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Nov 01 01:15:00 CST 2016, time=2016-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562400, encodeId=a787156240020, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Nov 01 01:15:00 CST 2016, time=2016-11-01, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=2033501, encodeId=4f47203350173, content=<a href='/topic/show?id=446044648ad' target=_blank style='color:#2F92EE;'>#女性患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44648, encryptionId=446044648ad, topicName=女性患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e0a1165, createdName=jiangfeng5067, createdTime=Tue Nov 08 07:15:00 CST 2016, time=2016-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1921050, encodeId=ea7b1921050c1, content=<a href='/topic/show?id=921b5e08167' target=_blank style='color:#2F92EE;'>#支持治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57081, encryptionId=921b5e08167, topicName=支持治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=640c454, 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objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14344, encryptionId=0c8814344f5, topicName=plant)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f5b299, createdName=xuyu, createdTime=Thu Nov 24 01:15:00 CST 2016, time=2016-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1691887, encodeId=b78d169188e8f, content=<a href='/topic/show?id=a450530853c' target=_blank style='color:#2F92EE;'>#患者预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53085, encryptionId=a450530853c, topicName=患者预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f4729287700, createdName=bnurmamat, createdTime=Mon May 29 19:15:00 CST 2017, time=2017-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1656732, encodeId=0a971656e3228, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Sat Jun 10 13:15:00 CST 2017, time=2017-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1796121, encodeId=b6f51e96121a4, content=<a href='/topic/show?id=691c1e765a0' target=_blank style='color:#2F92EE;'>#Transplant#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17765, encryptionId=691c1e765a0, topicName=Transplant)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=232a2500033, createdName=1249859em38(暂无昵称), createdTime=Mon Sep 11 13:15:00 CST 2017, time=2017-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157148, encodeId=e00315e148fc, content=介绍的很详细, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLAN4jREMZucufWSjHRyVSdVFDkx9nZbn3Dybooed1zgZzIEKYicfwKSREcTuRkwP19Q1TLbvZ424s/0, createdBy=1d791982726, createdName=一个知识的乞求者, createdTime=Sun Nov 20 23:34:59 CST 2016, time=2016-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356131, encodeId=06c613561312e, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Nov 01 01:15:00 CST 2016, time=2016-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562400, encodeId=a787156240020, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Nov 01 01:15:00 CST 2016, time=2016-11-01, status=1, ipAttribution=)]
    2017-06-10 bsmagic9140
  7. 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  8. 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13:15:00 CST 2017, time=2017-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157148, encodeId=e00315e148fc, content=介绍的很详细, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLAN4jREMZucufWSjHRyVSdVFDkx9nZbn3Dybooed1zgZzIEKYicfwKSREcTuRkwP19Q1TLbvZ424s/0, createdBy=1d791982726, createdName=一个知识的乞求者, createdTime=Sun Nov 20 23:34:59 CST 2016, time=2016-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356131, encodeId=06c613561312e, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Nov 01 01:15:00 CST 2016, time=2016-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562400, encodeId=a787156240020, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Nov 01 01:15:00 CST 2016, time=2016-11-01, status=1, ipAttribution=)]
    2016-11-20 一个知识的乞求者

    介绍的很详细

    0

  9. 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    2016-11-01 zhaojie88
  10. 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13:15:00 CST 2017, time=2017-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157148, encodeId=e00315e148fc, content=介绍的很详细, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLAN4jREMZucufWSjHRyVSdVFDkx9nZbn3Dybooed1zgZzIEKYicfwKSREcTuRkwP19Q1TLbvZ424s/0, createdBy=1d791982726, createdName=一个知识的乞求者, createdTime=Sun Nov 20 23:34:59 CST 2016, time=2016-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356131, encodeId=06c613561312e, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Nov 01 01:15:00 CST 2016, time=2016-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562400, encodeId=a787156240020, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Nov 01 01:15:00 CST 2016, time=2016-11-01, status=1, ipAttribution=)]
    2016-11-01 slcumt

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