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首页> 外文期刊>Chest >Influence of Gender on Rates of Hospitalization, Hospital Course, and Hypercapnea in High-Risk Patients Admitted for Asthma : A 10-year Retrospective Study at Yale-New Haven Hospital
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Influence of Gender on Rates of Hospitalization, Hospital Course, and Hypercapnea in High-Risk Patients Admitted for Asthma : A 10-year Retrospective Study at Yale-New Haven Hospital

机译：性别对哮喘高危患者的住院率，病程和高碳酸血症的影响：耶鲁-纽黑文医院的十年回顾性研究

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摘要

Study objectives: To compare the relative numbers and hospital course of men vs womennadmitted at least twice with asthma or status asthmaticus to Yale-New Haven Hospital (YNHH)nduring the period from 1985 to 1994.nDesign: A retrospective chart review.nSetting: YNHH.nPatients: High-risk men and women (age range, 18 to 50 years) admitted at least twice during thenstudy period with the discharge diagnosis of asthma or status asthmaticus.nResults: Of 561 adult asthma patients admitted during the study period, 188 were admitted atnleast twice and accounted for 68% of the total asthma admissions. One hundred three of the 188npatients were randomly selected, and all of their asthma admissions were retrospectivelynreviewed. The 103 patients accounted for 382 admissions. Seventy-two percent of these patientsnand 68.6% of the admissions were women. The proportions of each gender requiring admissionnto the medical ICU (15.65% women vs 11.67% men) or intubation (8.00% women vs 5.80% men)nwere not significantly different. Women did exhibit a definite trend toward longer admissionsn(4.92 days vs 4.04 days; p < 0.554). A significantly higher proportion of female patient admissionsnunderwent initial arterial blood gas analysis than men (56.9% vs 44.2%; p < 0.05). Factorialnanalysis demonstrated a highly significant main effect of gender on PCO2 levels (p < 0.0001).Men,noverall, had higher PCO2 levels than women (48.73 mm Hg vs 41.04 mm Hg; p < 0.036). Malenpatients admitted to the medical ICU or requiring intubation had significantly higher PCO2 levelsnthan their respective female counterparts (p < 0.05).nConclusions: At YNHH, 68% of all admissions for asthma in this age group are attributable tonhigh-risk patients. High-risk female patients are admitted twice as often as high-risk male patientsnand tend to have longer admissions. Once admitted, however, the proportion of men and womennrequiring the medical MICU or intubation were similar. High-risk male patients on presentationnare consistently more hypercapneic than high-risk female patients. Therefore, the mechanismsncontributing to the gender differences in asthma admissions may include differences in thenventilatory response to hypercapnea or in the tolerance to airway obstruction.
机译：研究目标：比较1985年至1994年期间耶鲁-纽黑文医院（YNHH）至少两次哮喘或患有哮喘病的男性和女性的相对人数和住院疗程.n设计：回顾性图表回顾。患者：年龄在18至50岁之间的高危男性和女性，在研究期间至少两次入院，出院诊断为哮喘或哮喘状态。n结果：在研究期间入组的561名成年哮喘患者中，有188名至少两次入院，占哮喘总入院人数的68％。随机选择了188名患者中的一百零三名患者，并对其所有哮喘患者进行了回顾性回顾。 103例患者中有382例入院。在这些患者中，有72％的患者是女性，占68.6％。需要入院ICU的男女比例（女性为15.65％，男性为11.67％）或气管插管（女性为8.00％，男性为5.80％）没有显着差异。女性确实表现出了入院时间更长的明确趋势n（4.92天vs 4.04天； p <0.554）。接受初次动脉血气分析的女性患者入院率明显高于男性（56.9％对44.2％； p <0.05）。析因分析表明，性别对PCO2水平具有非常显着的主要影响（p <0.0001）。男性（总体而言）的PCO2水平高于女性（48.73 mm Hg对41.04 mm Hg; p <0.036）。入院ICU或需要插管的男性患者的PCO2水平显着高于女性女性（p <0.05）。n结论：在YNHH，该年龄段哮喘患者中68％的患者归因于吨型高危患者。女性高危患者的住院率是男性高危患者的两倍，并且往往住院时间更长。但是，一旦被接受，需要医疗MICU或插管的男女比例是相似的。表现高危的男性患者始终比高危女性的患者高碳酸血症。因此，导致哮喘患者入院性别差异的机制可能包括对高呼吸的通气反应差异或对气道阻塞的耐受性差异。

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  • 来源
    《Chest》 |2001年第1期|p.115-119|共5页
  • 作者

    David R. Trawick Carole Holm and Joel Wirth;

  • 作者单位

    *From the Pulmonary and Critical Care Medicine Unit (Dr.Trawick), University of Rochester Medical Center, Rochester,NY, the Section of Pulmonary and Critical Care Medicine (Ms.Holm), Yale University School ofMedicine, New Haven, CT, andthe Division of Pulmonary and Critical Care Medicine (Dr.Wirth), Maine Medical Center, Portland, ME.,;

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  • 关键词

    asthma; gender; high-risk asthma; hospitalization; hypercapnea; near-fatal asthma; severity;

    机译：哮喘;性别;高危哮喘住院;高呼吸致命性哮喘严重程度;

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