Sex-Related Differences in Outcome in Patients with Aneurysmal Subarachnoid Hemorrhage

被引:17
|
作者
Duijghuisen, Jesse J. [1 ]
Greebe, Paut [1 ]
Nieuwkamp, Dennis J. [2 ]
Algra, Ale [1 ,3 ]
Rinkel, Gabriel J. E. [1 ]
机构
[1] Univ Med Ctr Utrecht, Brain Ctr Rudolf Magnus, Dept Neurol & Neurosurg, NL-3508 GA Utrecht, Netherlands
[2] Jeroen Bosch Hosp, Dept Neurol, Shertogenbosch, Netherlands
[3] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands
来源
关键词
Subarachnoid hemorrhage; outcome; case fatality; in-hospital death; sex; MORTALITY-RATES; STROKE; TRENDS;
D O I
10.1016/j.jstrokecerebrovasdis.2016.04.018
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Background: Several population-based studies found a higher case fatality after aneurysmal subarachnoid hemorrhage (ASAH) in women than in men. This may relate to differences in prognostic characteristics. We therefore assessed sex differences in prognosticators and outcome in ASAH patients. Methods: From a prospectively collected ASAH database, we retrieved data on patients admitted from 1990 to 2010. We calculated prevalence ratios (PRs) with corresponding 95% confidence intervals (CIs) for prognosticators (clinical condition on admission, site and treatment of the aneurysm, and complications during the clinical course) and risk ratios (RRs) for in-hospital death and poor outcome (death or dependence) at 3 months. RRs were adjusted for possible confounding with Poisson regression analysis. Results: Of the 1761 included patients, 1211 (68.8%) were women, who were 1.9 (95% CI: .5 <-> 3.3) years older than men. PRs for women for the site of the aneurysm were 1.71 (95% CI: 1.38 <-> 2.13) for the carotid artery, .68 (95% CI: .60 <->.77) for the anterior communicating artery, 1.14 (95% CI: .92 <-> 1.41) for the middle cerebral artery, and .85 (95% CI: .63 <-> 1.13) for posterior circulation. PRs of other prognosticators were similar between sexes. The crude RR for in-hospital death for women was .91 (95% CI: .78 <-> 1.05) and for poor outcome at 3 months was .95 (95% CI: .85 <-> 1.06); both remained similar after adjustment. Conclusions: In this study, in-hospital death and poor outcome at 3 months did not differ between men and women. Women were slightly older than men and had different distributions of aneurysm sites, but not to an extent that it explained a sex difference in outcome.
引用
收藏
页码:2067 / 2070
页数:4
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