基于性别和种族的肺动脉导管的使用和结果在全职重症监护人员的设置。

Micaela Iantorno, Julio A Panza, Nakela L Cook, Samantha Jacobs, Mary Beth Ritchey, Kathryn O'Callaghan, Daniel Caños, Howard A Cooper
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引用次数: 5

摘要

背景:关于危重病护理中性别或种族差异的了解甚少。我们调查了性别或种族是否与肺动脉导管(PAC)的使用或PAC患者的院内死亡有关。特别关注心源性休克(CS)患者,指南建议在这些患者中使用PAC。方法:这是一项回顾性队列分析,来自一家配备全职心脏强化医生的大型三级医院的冠状动脉监护室。结果:我们连续分析了8845例成年患者,其中42.1%为女性,40.8%为黑人。PAC使用率女性为11.3%,男性为11.5% (P = 0.79),黑人为11.3%,白人为11.5% (P = 0.76)。CS患者中,PAC的使用率男女分别为50.3%和49.1% (P = 0.85),黑人和白人分别为43.7%和53.3% (P = 0.05)。性别或种族与总体或CS患者的PAC使用没有独立关联。性别和种族都不是PAC患者院内死亡的预测因子。结论:PAC的使用和院内死亡不是由性别或种族决定的,而是由疾病严重程度决定的。全职的重症监护人员配备和明确的指导方针的存在可以减少基于性别和种族的治疗差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Gender- and race-based utilization and outcomes of pulmonary artery catheterization in the setting of full-time intensivist staffing.

Background: Little is known regarding gender- or race-based differences in critical care. We investigated whether gender or race was associated with pulmonary artery catheter (PAC) utilization or with in-hospital death among patients with a PAC. A particular focus was patients with cardiogenic shock (CS), in whom guidelines recommend PAC use.

Methods: This was a retrospective cohort analysis from the coronary care unit of a large tertiary-care hospital staffed with full-time cardiac intensivists.

Results: We analyzed 8845 consecutive adult patients, of whom 42.1% were women and 40.8% were black. PAC use rates were 11.3% in women and 11.5% in men (P = 0.79), and 11.3% in blacks and 11.5% in whites (P = 0.76). In CS patients, PAC use rates in women and men were 50.3% and 49.1% (P = 0.85) and in blacks and whites were 43.7% and 53.3% (P = 0.05). There was no independent association between gender or race and PAC use overall or in those with CS. Neither gender nor race was a predictor of in-hospital death in patients undergoing PAC.

Conclusions: PAC use and in-hospital death were determined not by gender or race but by disease severity. Full-time intensivist staffing and the presence of definitive guidelines may reduce gender- and race-based treatment disparities.

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