Abstract：
BACKGROUND: Cardiogenic shock (CS) is associated with significant morbidity and mortality. Sex differences in the outcomes and management of cardiogenic shock are not well established. The primary objective of this study is to investigate the differences inik cardiogenic shock outcomes between males and females.
METHODS: A systematic review and meta-analysis were conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Studies were searched via the MEDLINE/PubMed, EMBASE, and Cochrane Central Register of Controlled Trials databases from inception to December 2022.
RESULTS: The analysis included 24 studies comprising 1,567,660 patients. Compared to females, males with CS had a significantly lower risk of in-hospital all-cause mortality (risk ratio [RR] 0.88, 95 % confidence interval [CI] 0.85-0.90, p < 0.001) and 1-year mortality (RR 0.90, 95 % CI 0.89-0.92, p < 0.001). Males were more likely to undergo percutaneous coronary intervention (RR 1.21, 95 % CI 1.13-1.31, p < 0.0001) and intra-aortic balloon pump placement (RR 1.21, 95 % CI 1.11-1.32, p < 0.0001), with no significant sex differences in the use of extracorporeal membrane oxygenation or Impella. During the index hospitalization, males were at higher risk of arrhythmias (RR 1.18, 95 % CI 1.05-1.34, p = 0.003) and less likely to develop acute kidney injury (RR 0.86, 95 % CI 0.79-0.94, p < 0.001).
CONCLUSIONS: Men have a lower all-cause mortality risk in cardiogenic shock. Addressing disparities in management is crucial for improving CS outcomes, especially for women.
METHODS: A systematic review and meta-analysis were conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Studies were searched via the MEDLINE/PubMed, EMBASE, and Cochrane Central Register of Controlled Trials databases from inception to December 2022.
RESULTS: The analysis included 24 studies comprising 1,567,660 patients. Compared to females, males with CS had a significantly lower risk of in-hospital all-cause mortality (risk ratio [RR] 0.88, 95 % confidence interval [CI] 0.85-0.90, p < 0.001) and 1-year mortality (RR 0.90, 95 % CI 0.89-0.92, p < 0.001). Males were more likely to undergo percutaneous coronary intervention (RR 1.21, 95 % CI 1.13-1.31, p < 0.0001) and intra-aortic balloon pump placement (RR 1.21, 95 % CI 1.11-1.32, p < 0.0001), with no significant sex differences in the use of extracorporeal membrane oxygenation or Impella. During the index hospitalization, males were at higher risk of arrhythmias (RR 1.18, 95 % CI 1.05-1.34, p = 0.003) and less likely to develop acute kidney injury (RR 0.86, 95 % CI 0.79-0.94, p < 0.001).
CONCLUSIONS: Men have a lower all-cause mortality risk in cardiogenic shock. Addressing disparities in management is crucial for improving CS outcomes, especially for women.
摘要：
背景：心源性休克（CS）与显著的发病率和死亡率相关。心源性休克的结局和管理方面的性别差异尚不明确。这项研究的主要目的是调查男性和女性之间心源性休克结局的差异。
方法：使用系统评价和荟萃分析的首选报告项目（PRISMA）方法进行系统评价和荟萃分析。通过MEDLINE/PubMed搜索研究，EMBASE,和Cochrane中央对照试验注册数据库从成立到2022年12月。
结果：分析包括24项研究，包括1,567,660名患者。与女性相比，男性CS患者院内全因死亡率(风险比[RR]0.88,95%置信区间[CI]0.85-0.90,p<0.001)和1年死亡率(RR0.90,95%CI0.89-0.92,p<0.001)风险显著较低.男性更可能接受经皮冠状动脉介入治疗(RR1.21,95%CI1.13-1.31,p<0.0001)和主动脉内球囊反搏置入术(RR1.21,95%CI1.11-1.32,p<0.0001),在使用体外膜氧合或Impella方面没有显着的性别差异。在住院期间，男性发生心律失常的风险较高(RR1.18,95%CI1.05-1.34,p=0.003),发生急性肾损伤的可能性较低(RR0.86,95%CI0.79-0.94,p<0.001).
结论：男性心源性休克的全因死亡风险较低。解决管理方面的差异对于改善CS结果至关重要，尤其是对于女性。
方法：使用系统评价和荟萃分析的首选报告项目（PRISMA）方法进行系统评价和荟萃分析。通过MEDLINE/PubMed搜索研究，EMBASE,和Cochrane中央对照试验注册数据库从成立到2022年12月。
结果：分析包括24项研究，包括1,567,660名患者。与女性相比，男性CS患者院内全因死亡率(风险比[RR]0.88,95%置信区间[CI]0.85-0.90,p<0.001)和1年死亡率(RR0.90,95%CI0.89-0.92,p<0.001)风险显著较低.男性更可能接受经皮冠状动脉介入治疗(RR1.21,95%CI1.13-1.31,p<0.0001)和主动脉内球囊反搏置入术(RR1.21,95%CI1.11-1.32,p<0.0001),在使用体外膜氧合或Impella方面没有显着的性别差异。在住院期间，男性发生心律失常的风险较高(RR1.18,95%CI1.05-1.34,p=0.003),发生急性肾损伤的可能性较低(RR0.86,95%CI0.79-0.94,p<0.001).
结论：男性心源性休克的全因死亡风险较低。解决管理方面的差异对于改善CS结果至关重要，尤其是对于女性。
