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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Sex-Related Differences in the Risk of Hospital-Acquired Sepsis and Pneumonia Post Acute Ischemic Stroke
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Sex-Related Differences in the Risk of Hospital-Acquired Sepsis and Pneumonia Post Acute Ischemic Stroke

机译：与医院败血症和肺炎后急性缺血性卒中风险的性与性差异

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Background and Objective: Infectious complications after ischemic stroke are frequent and lead to neurological deterioration, poor functional outcomes, and higher mortality. Local and systemic inflammatory responses to brain ischemia differ between males and females, but little is known about differences in poststroke susceptibility to infection by sex. The purpose of this study was to compare sex-related differences in the risk of hospital-acquired sepsis and pneumonia after acute ischemic stroke (AIS). Materials and Methods: This is a retrospective, secondary analysis of the 2010-2011 California State Inpatient Database. Previously validated International Classification of Disease, Ninth Revision (ICD-9) codes were used to identify adult hospitalizations for AIS. The primary outcome was hospital-acquired sepsis or pneumonia, also identified using ICD-9 codes. Associations between sex and hospital-acquired sepsis or pneumonia were adjusted for baseline characteristics and comorbidities using multivariable logistic regression. Results: There were 91,643 hospitalizations for AIS included in this analysis, of which 1027 had hospital-acquired sepsis and 1225 had hospital-acquired pneumonia. The in-hospital mortality without infection was 4.6%; the presence of hospital-acquired infections was associated with higher mortality for sepsis (32.7%) and pneumonia (21.9%). Female (versus male) sex was associated with lower adjusted odds of hospital-acquired sepsis (odds ratio [OR].74, 95% confidence interval [CI].65-.84) and pneumonia (OR.69, 95% CI.62-.78). This difference was similar across age strata. Among hospitalizations with either hospital-acquired sepsis or pneumonia, sex did not influence mortality. Conclusions: Female sex was associated with a lower risk of hospital-acquired sepsis and pneumonia after AIS. Further investigation is needed to determine the mechanisms underlying this clinical observation.
机译：背景和目的：缺血性中风后的感染性并发症很常见，会导致神经功能恶化、功能不良和更高的死亡率。脑缺血的局部和全身炎症反应在男性和女性之间存在差异，但关于中风后感染易感性的性别差异知之甚少。本研究的目的是比较急性缺血性卒中（AIS）后医院获得性败血症和肺炎风险的性别差异。材料和方法：这是对2010-2011年加利福尼亚州住院患者数据库的回顾性二次分析。之前经过验证的国际疾病分类第九修订版（ICD-9）代码被用于识别成人AIS住院情况。主要结果是医院获得性败血症或肺炎，也使用ICD-9代码识别。使用多变量逻辑回归对性别与医院获得性败血症或肺炎之间的相关性进行基线特征和共病调整。结果：本分析包括91643例AIS住院病例，其中1027例为医院获得性败血症，1225例为医院获得性肺炎。无感染住院死亡率为4.6%；医院获得性感染与败血症（32.7%）和肺炎（21.9%）的较高死亡率相关。女性（与男性相比）性别与医院获得性败血症（优势比[OR].74,95%可信区间[CI].65-.84）和肺炎（OR.69,95%可信区间[CI.62-.78]）的调整后优势度较低有关。这一差异在不同年龄层之间是相似的。在医院获得性败血症或肺炎的住院患者中，性别不影响死亡率。结论：女性性别与AIS后医院获得性败血症和肺炎的风险较低有关。需要进一步的研究来确定这一临床观察背后的机制。

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