■很少有研究评估感染性心内膜炎患者性别与预后之间的关系。这项研究的目的是更好地理解生物性别之间的联系,临床结局和手术治疗模式在当代住院的感染性心内膜炎患者队列中.
■我们使用医疗保健利用项目的全国住院患者样本数据集来确定2016年1月至12月期间因感染性心内膜炎入院的成年患者。我们比较了男性和女性之间的结果,包括住院死亡率,医院直接费用,逗留时间,和住院手术治疗模式。多变量分析进行了调整年龄,社会经济地位,和合并症负担。
■在18,702例感染性心内膜炎患者中,有8730例(46.7%)女性和1753例(8.4%)住院死亡.在多变量分析中,女性与住院死亡率降低趋势相关(校正比值比(OR)0.90;95%置信区间(CI)0.80~1.01,p=0.06).此外,女性患者的住院时间显著缩短(-0.5日;95%CI-0.88~-0.12,p=0.009),住院费用降低(-3035美元;95%CI-4277~-1792美元;p<0.001).值得注意的是,女性接受手术干预的可能性较小(校正OR0.59;95%CI0.52~0.67,p<0.001).
■在当代,在美国,有全国代表性的IE患者队列,在管理和住院结局方面存在性别特异性差异.感染性心内膜炎的治疗模式和住院手术干预中可能存在的基于性别的偏见值得进一步研究。
UNASSIGNED: Few studies have assessed the association between sex and outcomes among patients with infective endocarditis. The aim of the study was to better understand the association between biologic sex, clinical outcomes and surgical treatment patterns among a contemporary cohort of patients admitted to hospital with infective endocarditis.
UNASSIGNED: We used the National Inpatient Sample dataset from the Health Care Utilization Project to identify adult patients admitted for infective endocarditis between January and December 2016. We compared outcomes between men and women including inpatient hospital mortality, direct hospital costs, length of stay, and inpatient surgical treatment patterns. Multivariable analyses were performed with adjustment for age, socioeconomic status, and comorbidity burden.
UNASSIGNED: Among 18,702 patients with infective endocarditis, there were 8730 (46.7%) women and 1753 (8.4%) in-hospital deaths. In multivariable analysis, female sex was associated with a trend toward lower in-hospital mortality (adjusted odds ratio (OR) 0.90; 95% confidence interval (CI) 0.80 to 1.01, p = 0.06). Additionally, female sex was associated with significantly shorter hospital length of stay (-0.5 days; 95% CI -0.88 to -0.12, p = 0.009) and lower hospital costs (-$3035; 95% CI -$4277 to -$1792; p < 0.001). Notably, women were less likely to undergo surgical intervention (adjusted OR 0.59; 95% CI 0.52 to 0.67, p < 0.001).
UNASSIGNED: In a contemporary, nationally representative cohort of patients admitted for IE in the United States, there were sex-specific differences in management and in-hospital outcomes. Possible sex-based bias in treatment patterns and access to inpatient surgical intervention for infective endocarditis warrants further study.