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Stroke:缺血性卒中护理中的男女“不平等”

2016-08-24 fsy 译 MedSci原创

卒中护理中,包括溶栓治疗和早期入院的性别特异性差异都经过了报道。

卒中护理,包括溶栓治疗和早期入院的性别特异性差异都经过了报道。在一项大型注册研究中,佛罗里达州和波多黎各州的各个医院都参与了“遵循指南”的项目(Get With The Guidelines,GWTG)——卒中项目,研究人员试图确定在缺血性卒中的性能指标和整体溶栓治疗方面的性别特异性差异。

从2010年至2014年,来自73个地点的大约51317例患者(49%的参与者为女性)参与了此研究。多因素Logistic回归与广义估计方程评估了在“遵循指南”——卒中项目中预先设定的缺血性脑卒中无缺陷护理指标的性别特异性差异,并对年龄,种族,保险状况,医院的特点,个人的风险因素,和每个人的卒中严重程度进行了调整。

与男性相比,女性的年龄都较大(73±15 vs 69±14岁; P<0.0001),更多的女性患者有高血压(67% vs 63%,P<0.0001)和房颤(19% vs 16%; P<0.0001)。女性无缺陷护理的比例比男性略低(比值比为0.96;95%置信区间,0.93-1.00)。男性和女性无缺陷护理的时间趋势都大幅改善,两组改善程度基本上相似,女性中有29%的绝对改善(P<0.0001),男性中有28%的绝对改善(P<0.0001),时间和性别相互影响的P值为0.13。与男性相比,有更少的女性接受溶栓治疗(比值比,0.92; 95%置信区间,0.86-0.99; P=0.02),入院至溶栓开始的时间<1小时的女性也比较少(比值比,0.83; 95%置信区间,0.71-0.97; P=0.02)。

在这项注册研究中,女性接受了和男性一样的卒中护理,并且这些参与者都接受了“遵循指南”项目预先设定指标的评估。然而,更少的女性接受溶栓治疗,并且入院至溶栓开始的时间<1小时的女性也比较少,因此还需要干预方法的实施,来减少这些措施中的性别差异。

原始出处:

Negar Asdaghi,Jose G. Romano,Kefeng Wang,et al.Sex Disparities in Ischemic Stroke Care,Stroke,2016.8.25

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    2016-10-07 ylzr123

    好文,从这里学习了好多新知识,新信息。赞了!

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1892788, encodeId=a2641892e88b7, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Tue Dec 20 12:05:00 CST 2016, time=2016-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806105, encodeId=1766180610503, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Wed Oct 05 14:05:00 CST 2016, time=2016-10-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=141555, encodeId=c6fc141555d9, content=好文,从这里学习了好多新知识,新信息。赞了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Fri Oct 07 20:06:19 CST 2016, time=2016-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=109971, encodeId=bf6d1099e1ea, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Fri Sep 02 23:59:00 CST 2016, time=2016-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105010, encodeId=5eb8105010b7, content=学习了,赞一个!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Fri Aug 26 19:37:00 CST 2016, time=2016-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105013, encodeId=aa2b10501383, content=学习了,赞一个!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Fri Aug 26 19:37:00 CST 2016, time=2016-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105015, encodeId=d4e910501566, content=学习了,赞一个!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Fri Aug 26 19:37:00 CST 2016, time=2016-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105016, encodeId=ba6a1050163d, content=学习了,赞一个!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Fri Aug 26 19:37:00 CST 2016, time=2016-08-26, status=1, ipAttribution=)]
    2016-09-02 李东泽

    很好,不错,以后会多学习

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1892788, encodeId=a2641892e88b7, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Tue Dec 20 12:05:00 CST 2016, time=2016-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806105, encodeId=1766180610503, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Wed Oct 05 14:05:00 CST 2016, time=2016-10-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=141555, encodeId=c6fc141555d9, content=好文,从这里学习了好多新知识,新信息。赞了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Fri Oct 07 20:06:19 CST 2016, time=2016-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=109971, encodeId=bf6d1099e1ea, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Fri Sep 02 23:59:00 CST 2016, time=2016-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105010, encodeId=5eb8105010b7, content=学习了,赞一个!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Fri Aug 26 19:37:00 CST 2016, time=2016-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105013, encodeId=aa2b10501383, content=学习了,赞一个!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Fri Aug 26 19:37:00 CST 2016, time=2016-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105015, encodeId=d4e910501566, content=学习了,赞一个!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Fri Aug 26 19:37:00 CST 2016, time=2016-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105016, encodeId=ba6a1050163d, content=学习了,赞一个!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Fri Aug 26 19:37:00 CST 2016, time=2016-08-26, status=1, ipAttribution=)]
    2016-08-26 1dd8a7c5m95(暂无匿称)

    学习了,赞一个!!!

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1892788, encodeId=a2641892e88b7, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Tue Dec 20 12:05:00 CST 2016, time=2016-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806105, encodeId=1766180610503, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Wed Oct 05 14:05:00 CST 2016, time=2016-10-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=141555, encodeId=c6fc141555d9, content=好文,从这里学习了好多新知识,新信息。赞了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Fri Oct 07 20:06:19 CST 2016, time=2016-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=109971, encodeId=bf6d1099e1ea, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Fri Sep 02 23:59:00 CST 2016, time=2016-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105010, encodeId=5eb8105010b7, content=学习了,赞一个!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Fri Aug 26 19:37:00 CST 2016, time=2016-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105013, encodeId=aa2b10501383, content=学习了,赞一个!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Fri Aug 26 19:37:00 CST 2016, time=2016-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105015, encodeId=d4e910501566, content=学习了,赞一个!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Fri Aug 26 19:37:00 CST 2016, time=2016-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105016, encodeId=ba6a1050163d, content=学习了,赞一个!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Fri Aug 26 19:37:00 CST 2016, time=2016-08-26, status=1, ipAttribution=)]
    2016-08-26 1dd8a7c5m95(暂无匿称)

    学习了,赞一个!!!

    0

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    2016-08-26 1dd8a7c5m95(暂无匿称)

    学习了,赞一个!!!

    0

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