Stroke:美国人的静脉溶栓概率居然与种族有关!

2017-03-14 MedSci MedSci原创

静脉溶栓(IVT)在少数民族和妇女中没有得到充分使用。为了评估决定IVT使用差异的个体和系统的因素,近期,一项发表在杂志Stroke上的研究调查了不同比例的少数民族患者就诊的医院中IVT利用率的种族/性别差异。此项研究选取自2007年至2011年间全国住院人群中确诊为缺血性卒中的患者。根据少数民族卒中患者比例将医院分类(<25%的少数民族患者[白色医院],25%至50%的少数民族患者[混合医

静脉溶栓(IVT)在少数民族和妇女中没有得到充分使用。为了评估决定IVT使用差异的个体和系统的因素,近期,一项发表在杂志Stroke上的研究调查了不同比例的少数民族患者就诊的医院中IVT利用率的种族/性别差异。


此项研究选取自2007年至2011年间全国住院人群中确诊为缺血性卒中的患者。根据少数民族卒中患者比例将医院分类(<25%的少数民族患者[白色医院],25%至50%的少数民族患者[混合医院] ,或> 50%的少数民族患者[少数民族医院])。使用Logistic回归来评估不同医院层内的种族/性别和IVT使用之间的关联。

此项研究结果显示:在337201例卒中患者住院中,白种人男性在任何医院层中的所有种族/性别组中的IVT几率最高,白人男性的IVT几率没有因医院分层而不同。对于白人妇女和少数民族男子,少数民族医院的IVT几率明显低于白人医院(白人妇女:优势比为0.83; 95%置信区间为0.71-0.97;少数民族男子:优势比为0.82; 95%置信区间,0.69-0.99)。在白人医院中观察到女性IVT使用的种族差异(优势比为0.88; 95%置信区间为0.78-0.99,少数民族与白人女性相比),但在少数民族医院中没有(优势比为0.94,95%置信区间,0.82-1.09)。在白人中观察到IVT使用中的性别差异,但在少数群体之间没有观察到。

此项研究表明:与白人医院相比,少数民族医院的少数民族男性和白人妇女的IVT几率显着降低。白人男性的IVT使用不因医院不同而异。

原始出处:
Faigle R, Urrutia VC, et al. Individual and System Contributions to Race and Sex Disparities in Thrombolysis Use for Stroke Patients in the United States. Stroke. 2017 Mar 10. pii: STROKEAHA.116.015056. doi: 10.1161/STROKEAHA.116.015056.

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    2017-04-19 fusion
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    2017-03-15 1e10eabem79(暂无匿称)

    受教了,启发很大

    0

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    2017-03-15 绛珠草小姐

    好好学习,谢谢了

    0

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    2017-03-14 清幽蓝燕yan

    感谢作者链接

    0

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    2017-03-14 1e160a78m83(暂无匿称)

    学习啦谢谢分享

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